胆囊切除术对外周血T细胞亚群和NK细胞的影响

The Influence of Cholecystectomy on Lymphocyte Subsets and Natural Killer Cells

本文应用抗人淋巴细胞单克隆抗体,检测了14例因胆囊结石行择期胆囊切除术患者围手术期外周血T细胞亚群和自然杀伤(NK)细胞的变化。结果发现,术后1d,Leu4 (总T细胞),Leu 3a(辅助/诱导T细胞)和NK细胞均明显下降,Leu 3a/Leu 2a(抑制/细胞毒T细胞)比值下降,与术前水平相比,均有显著性差异(P<0.05,<0.01)。上述现象持续至术后4d,于术后7d恢复正常。本研究结果表明手术创伤介导的免疫功能低下可能与术后感染易感性增加有关。

The increased susceptibility of severely injured patients to infection and death from sepsis have been attributed to abnormalities in cell-mediated immunity. We therefore assessed lymphocyte subsets and natural killer (NK) cells identified by specific monoclonal antibodies in 14 patients undergoing routine cholecystectomy before operation and on postoperative days(POD) 1, 4 and 7. The results showed that on POD 1 and 4, the percentages of Leu 4 (Pan T lymphocyte) and Leu 3a (T-helper) cells fell significantly and there was a significant reduction in ratio of Leu 3a to Leu 2a (T-suppressor) cells. Furthermore, the percentage of NK cells was also significantly decreased. The altered percentages of lymphocyte subsets and NK cells returned to normal on POD 7. From the above it may be concluded that marked abnormalities in cell-mediated immunologic function, as determined by lymphocyte subsets, occur immediately after surgical operation and such suppression may be attributed to the increased susceptibility to postoperative infection.