胰十二指肠切除术对老年患者免疫功能的影响

The changes of immune function in elderly patients after pancreaticoduodenectomy

[目的]探讨胰十二指肠切除术对老年患者免疫功能的影响。[方法]随机选取62例胰十二指肠切除术的患者,根据年龄将其分成老年组(≥60周岁)和中青年组(<60周岁),分别测定分析2组术前1天及术后第1天、第3天、第7天的外周血血常规、降钙素原(PCT)、NK细胞(CD16+CD56+)、白细胞及T淋巴细胞亚群的数量。[结果]老年组和中青年组术后第1天、第3天与术前相比白细胞数均显著增高(P<0.05);老年组术后第1天、第3天、第7天白细胞数显著高于中青年组(P<0.05)。老年组和中青年组术后第1天、第3天PCT均显著高于术前(P<0.05);老年组术后第3天、第7天PCT明显低于中青年组(P<0.05)。老年组术前及术后第3天、第7天NK细胞数低于中青年组,但2组间比较差异无统计学意义(P>0.05)。老年组术前及术后第1天、第3天、第7天CD4+/CD8+值均低于中青年组(P<0.05)。[结论]胰十二指肠切除术对不同年龄患者免疫功能影响存在差异,且会影响老年患者细胞免疫功能,并使其术后感染的风险增大。

[Objective] To investigate the changes of immune function in elderly patients after pancreaticoduodenectomy. [Methods] Sixty-two patients underwent pancreaticoduodenectomy during March 2013-March 2017 were involved. The patients were divided into two different groups according to ages （≥ 60 years or〈60 years）. NK cells（CD16＋CD56＋）,CD4＋/CD8＋cell ratio, WBC and PCT were analyzed in the two groups before and 1,3,7 days after the operation. [ResultsjThe postoperative WBC in 1 d,3 d in both elderly group and young group were significantly higher than preoperation（P〈0. 05） . The postoperative WBC 1 d, 3 d, 7 d in elderly group were significantly higher than those in young group （P〈0. 05）. The postoperative PCT in 1 d,3 d in both elderly group and young group were significantly higher than those in preoperation（P〈0. 05）. The postoperative PCT in 3 d,7 d in elderly group was lower than those in young group（P〈0. 05）. The NK（CD16＋CD56＋）cell counts in preoperation and postoperative 3 d,7 d in elderly group tend to be lower than young group（P〉0. 05）. The preoperative and postoperative CD4＋ CD8＋ camper in 1 d,3d,7 d in elderly group were lower than young group（P〈0. 05）. [Conclusion]Pancreaticoduodenectomy affect differently in immune function for patients with different ages, which could increase the risk of postoperative infection.