腹腔镜胆囊切除术对老年患者免疫功能的影响

Effect of laparoscopic cholecystectomy on immune function in aged patients

[目的]比较腹腔镜胆囊切除术对老年患者免疫功能的影响。[方法]随机选择择期行腹腔镜胆囊切除术的80例患者,按年龄分为老年组(≥60岁)与中青年组(<60岁)。测定并分析2组术前及术后第1、3、7天外周血白细胞、淋巴细胞、T淋巴细胞及其亚群的数量。[结果]中青年组术后第1天表现出CD3、CD4T淋巴细胞数量下降的趋势,术后第3天恢复正常;而老年组在术后第3天表现出CD3和CD4T淋巴细胞数量下降,术后第7天恢复到术前水平。[结论]腹腔镜胆囊切除术对不同年龄患者机体免疫功能的影响存在差异。老年患者由于自身免疫系统机能的减退,较易出现"反应延迟"现象。

[Objective]To investigate the effect of laparoscopic cholecystectomy（LC）on immune function in aged patients.[Methods]Eighty patients with operation indication for LC were enrolled.The levels of peripheral blood leukocyte,lymphocyte,T-lymphocyte and subsets were measured and compared in groups divided by age.[Results]The baseline of peripheral blood lymphocyte in aged patients was lower than juniors,especially of CD3,CD8 T-lymphocyte.Surgical stress leaded to the decline of CD3,CD4 T-lymphocytes in young group on postoperative 1st day,which recovered to the preoperative level on postoperative 3rd day;while,the changes in the elderly group occurred on the 3rd day and recovered on postoperative 7th day.[Conclusion]LC has different effect on immune function of patients with different age.Elderly patients are easy to present the delayed response.