摘要
目的探讨全胃切除横结肠代胃术对胃癌患者术后免疫功能的影响。方法167例胃癌患者按均衡随机分组的方法分为对照组与研究组，对照组采用传统食管一空肠Schlatter吻合术（术式Ⅰ）和食管-空肠Roux—en—Y吻合术（术式Ⅱ）重建消化道，研究组以横结肠代胃术重建消化道。分别于术前第1天、术后第1天、术后第9天观察患者T细胞亚群和IL-2、红细胞免疫功能、急性炎症介质的变化，并分析两组患者术后病死率。结果术后第1天，对照组CD4＋T细胞、CD8＋T细胞比例分别为（40．61±5．27）％、（28．43±3．21）％，研究组CD4＋T细胞、CD8＋T细胞比例分别为（41．15±5．30）％、（27．56±3．09）％，两者差异均无统计学意义（P〉0．05）。对照组IL-2水平为（1．40±0．22）μg／L，研究组IL-2水平为（1．39±0．21）μg／L，两者差异无统计学意义（P〉0．05）。对照组红细胞C3b受体花环率、红细胞免疫复合物花环率分别为（26．79±6．33）％、（26．62±5．81）％，研究组红细胞C3b受体花环率、红细胞免疫复合物花环率分别为（28．95±6．52）％、（24．69±5．60）％，两者之间差异均无统计学意义（P〉0．05）。对照组IL-6表达水平为（162．71±25．42）pg／mL，研究组IL-6表达水平为（158．83±22．45）pg／mL，两者之间差异无统计学意义（P〉0．05）。术后第9天，对照组CD4＋T细胞、CD8＋T细胞比例分别为（44．68±5．92）％、（27．21±3．07）％，研究组CD4＋T细胞、CD8＋T细胞比例分别为（48．75±6．24）％、（24．26±2．39）％，两者之间比较差异均具有统计学意义（P〈0．05）。对照组IL-2水平为（1．49±0．32）μg/L，研究组IL-2水平为（1．67±0．35）μg／L，两者之间差异有统计学意义（P〈0．05）。对照组红细胞C3b受体仡环率为（30．25±6．65）％，研究组红细胞C3b受体花环率为�
Objective To explore the effect on immunologic function of gastric carcinoma patients after operation by transposition of a transverse colon segment as a gastric reservoir following total gastrectomy. Methods A prospective, randomized, double-blind clinical trial was performed. One hundred and sixty- seven gastric carcinoma patients were divided into control group and research group in terms of balanced ran- dom groups. We reconstructed digestive tract with conventional Schlatter esophagojejunostomy and Roux-en- Y esophagojejunostomy in control group, while we reconstructed digestive tract with transposition of a trans- verse colon segment as a gastric reservoir in research group, the changes of T cell subset, IL-2, immunolog- ic function of red blood cell, acute inflammatory mediator were analyzed in the patients respectively at the first day before operation, at the first day after operation, at the ninth day after operation. Postoperative fa- tality rate was also detected in two groups. Results Compared with control group, The changes of T cell subset, IL-2 had no significant differences in research group at the first day after operation （P 〉 0.05 ）. chaplet Meanwhile, the changes of C3b receptor chaplet rate and immunocomplex receptor rate had no signif- icant differences in research group compared with control group at the first day after operation （ P 〉 0.05 ）. There were no obvious differences for acute inflammatory mediators between two groups at the first day after operation （P 〉 0.05）. At the ninth day after operation, the levels of CD4 ＋ （44.68 ± 5.92） % in control group were obviously lower than those （48.75 ± 6.24） % in research group （P 〈 0.05 ）. However, the per- centage of CD8 ＋ T cells （27.21 ± 3.07 ）% in control group was significantly higher than that （24.26 ±2.39）% in research group （P〈 0. 05）. The levels of IL-2 in control group and research group were （ 1.49 ± 0.32） μg/L and （ 1.67 ± 0.35 ） μg/L, with obvious differences betwe
出处
《国际外科学杂志》
2013年第1期22-26,共5页
International Journal of Surgery
关键词
胃切除术
横结肠代胃
胃肿瘤
免疫
Gastrectomy
Transposition of a transverse colon segment as a gastric reservoir
Stomach neoplasms
Immunity
