肝癌患者术后肺部感染对机体免疫功能及RAAS的影响及机制研究

Influence of postoperative pulmonary infection on immune function and RAAS in patients with hepatocellular carcinoma and its mechanism

目的探讨肝癌患者术后肺部感染对机体免疫功能和肾素-血管紧张素-醛固酮系统(RAAS)的影响。方法选取2017年1月至2018年1月于我院行手术治疗的130例肝癌患者为考察对象,并依据患者术后肺部感染与否分为感染组(n=43)和非感染组(n=87)。测定2组手术前后免疫功能、RAAS系统、营养状态及其他血生化指标水平变化。结果与术前相比,术后感染组患者CD3+T淋巴细胞比例、CD4+/CD8+、NK细胞比例及IgM、IgG、IgA水平、总蛋白、白蛋白水平均明显降低(P <0.01),且显著低于非感染组(P <0.01)。与术前相比,术后2组Ang-Ⅱ、ALD、NE水平以及MMP-1、MMP-2、MMP-9水平均明显升高(P <0.01),且感染组显著高于非感染组(P <0.01)。结论肝癌术后肺部感染可对患者免疫系统和RAAS系统产生更深的影响,而明确术后感染原因和发病机制对提高患者预后效果具有重要意义。

Objective To investigate the effects of postoperative pulmonary infection on immune function and renin angiotensin aldosterone system(RAAS)in patients with liver cancer.Methods 130 cases of liver cancer were selected from January 2017 to January 2018 in our hospital,and the patients were divided into infection group(n=43)and non infection group(n=87)according to the postoperative pulmonary infection.The changes of immune function,RAAS system,nutritional status and other blood biochemical indexes in 2 groups before and after operation were measured and compared.Results Compared with pre operation,the CD3+T lymphocyte ratio,CD4+/CD8+and NK cells,IgM,IgG,IgA,total protein and albumin levels in the infected group were significantly lower than those in the non-infected group(P﹤0.01).The levels of Ang-II,ALD,NE,MMP-1,MMP-2 and MMP-9 in the two groups were significantly higher than those before operation(P﹤0.01),and those in the infected group were significantly higher than those in the non-infected group(P﹤0.01).Conclusion Infection after liver cancer can have a further influence on the immune and RAAS system,and the cause and mechanism of postoperative infection are of great significance to improve the prognosis of the patients.