术后肺部感染对肝癌脊柱转移患者免疫系统和内分泌系统的影响

Influence of postoperative pulmonary infection on immune system and endocrine system of patients with spinal metastases from liver cancer

目的探究肝癌脊柱转移患者术后肺部感染对其免疫系统和内分泌系统的影响。方法选取2018年1月-2019年1月于唐山市第二医院接受手术治疗的114例肝癌脊柱转移患者为研究对象,根据患者术后是否发生肺部感染分为两组,其中发生肺部感染的47例患者为研究组,未发生肺部感染的67例患者为对照组。比较两组患者手术前后指标水平。结果手术治疗前,两组患者各指标比较无显著差异。手术治疗后研究组患者细胞免疫指标CD3^+T淋巴细胞(50.49±5.38)%、CD4^+/CD8^+比值(1.53±0.33)、NK细胞[(11.24±4.38)]×10^9/L均低于对照组(P<0.05);手术治疗后研究组患者体液免疫指标IgM、IgG、IgA水平分别为(1.09±0.34)g/L、(10.08±2.43)g/L、(1.87±0.52)g/L均低于对照组(P<0.05);手术治疗后研究组患者内分泌系统指标血管紧张素(Angiotensin, Ang-II)、去甲肾上腺素(Norepinephrine,NE)、醛固酮(Aldosterone,ALD)水平分别为(73.20±5.77)ng/L、(75.68±6.39)μg/L、(44.23±3.41)ng/L均高于对照组患者(P<0.05);手术治疗后研究组患者总蛋白(50.18±4.68)g/L和白蛋白(25.20±3.97)g/L水平均低于对照组,基质金属蛋白酶-1水平(7.88±0.38)ng/L高于对照组(P<0.05)。结论肝癌脊柱转移患者手术后发生肺部感染会引起患者免疫系统和内分泌系统失调,导致免疫指标水平下降,内分泌指标发生紊乱,不利于患者营养水平的提高。

OBJECTIVE To explore the influence of postoperative pulmonary infection on immune system and endocrine system of the patients with spinal metastases from liver cancer.METHODS A total of 114 patients with spinal metastases from liver cancer who underwent surgical procedures in Tangshan Second Hospital from Jan 2018 to Jan 2019 were recruited as the study objects and divided into two groups according to the status of postoperative pulmonary infection,47 patients who had pulmonary infection were assigned as the study group,and 67 patients who did not pulmonary infection were set as the control group.The levels of indexes were observed and compared between the two groups of patients before and after the surgery.RESULTS There were no significant differences in the indexes between the two groups of patients before the surgery procedures.The cellular immune indexes CD3^+T lymphocyte,ratio of CD4^+to CD8^+and NK cells of the study group were respectively(50.49±5.38)%,(1.53±0.33)and[(11.24±4.38)]×10^9/L after the surgical procedures,significantly lower than those of the control group(P<0.05).The levels of humoral immunity indexes IgM,IgG and IgA of the study group were respectively(1.09±0.34)g/L,(10.08±2.43)g/L and(1.87±0.52)g/L after the surgical procedures,significantly lower than those of the control group(P<0.05).The levels of endocrine system indexes angiotensin(Ang-II),norepinephrine(NE)and aldosterone(ALD)of the study group were respectively(73.20±5.77)ng/L,(75.68±6.39)μg/L and(44.23±3.41)ng/L after the surgical procedures,higher than those of the control group(P<0.05).The levels of total protein and albumin of the study group were respectively(50.18±4.68)g/L and(25.20±3.97)g/L after the surgical procedures,significantly lower than those of the control group;the matrix metalloproteinase-1 of the study group was(7.88±0.38)ng/L,significantly higher than that of the control group(P<0.05).CONCLUSION The postoperative pulmonary infection in the patients with spinal metastases from liver cancer may result in the disorder of immune system and endocrine system,the decline of the levels of immune indexes and the disorder of endocrine indexes,which is not conducive to the improvement of patients′nutritional level.