摘要
目的探究T淋巴细胞亚群与结核性腹膜炎(TBP)合并肠梗阻术后并发症的相关性。方法回顾性分析2005年5月—2013年5月首都医科大学附属北京天坛医院收治的318例TBP合并肠梗阻患者的临床资料。患者均接受手术治疗,根据术后是否发生并发症将患者分为发生组、未发生组,比较发生组与未发生组术前外周血和腹水中CD3^(+)、CD4^(+)、CD8^(+)比率及CD4^(+)/CD8^(+)比值及其他可能导致术后并发症发生的影响因素的差异,并采用Logistic回归分析法明确导致术后并发症的危险因素。结果318例患者术后发生并发症64例,总发生率为20.13%,其中切口感染发生率最高(5.03%),腹腔感染及肠粘连发生率最低(1.89%)。TBP合并肠梗阻患者外周血CD8^(+)比率较腹水升高,CD3^(+)、CD4^(+)比率及CD4^(+)/CD8^(+)比值均较腹水降低(P<0.05)。未发生组和发生组外周血CD8^(+)比率较腹水升高,CD3^(+)、CD4^(+)比率及CD4^(+)/CD8^(+)比值均较腹水降低(P<0.05);发生组外周血和腹水中CD4^(+)比率及CD4^(+)/CD8^(+)比值均低于未发生组(P<0.05)。发生组贫血、急性生理学及慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分≥14分、手术时间≥3 h患者比率高于未发生组(P<0.05)。经Logistic回归分析,腹水和外周血中CD4^(+)/CD8^(+)比值、贫血、APACHE Ⅱ评分、手术时间≥3 h均为TBP合并肠梗阻术后并发症的危险因素(P<0.05)。结论TBP合并肠梗阻患者存在全身性细胞免疫低下、腹腔局部细胞免疫增强现象,且腹水和外周血中CD4^(+)/CD8^(+)比值与术后并发症发生关系密切,对指导临床并发症防治有重要价值。
Objective To investigate the correlation between T lymphocyte subsets and postoperative complications of tuberculous peritonitis(TBP)combined with intestinal obstruction.Methods Clinical data of 318 patients with TBP and intestinal obstruction admitted to the hospital from May 2005 to May 2013 in Beijing Tiantan Hospital Affiliated to Capital Medical University were retrospectively analyzed.They all were treated with surgery,and divided into the occurrence group and the non-occurrence group according to whether complications occurred after the operation.The ratio of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in perioperative period and ascites before the operation and other factors that may lead to postoperative complications were compared between the groups.The risk factors of postoperative complications were determined by logistic regression analysis.Results There were 64 postoperative complications in 318 patients,the total incidence was 20.13%,of which incision infection was the highest(5.03%),abdominal infection and in⁃testinal adhesion were the lowest(1.89%).The ratio of CD8^(+)in peripheral blood of the TBP patients with ileus was higher than that in ascites,and the ratio of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were lower than those of ascites(P<0.05).The ratio of CD8^(+)in peripheral blood of the non-occurrence group and occurrence group were higher than those in ascites,and the ratio of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were lower than those of ascites(P<0.05).The ratio of CD4^(+)and CD4^(+)/CD8^(+)in peripheral blood and ascites in the occurrence group were lower than those in the non-occurrence group(P<0.05).The proportion of anemia,acute physiology and chronic health evaluation scoring system Ⅱ(APACHE Ⅱ)score≥14 and operation time≥3 hours in the occurrence group were higher than those in the non occurrence group(P<0.05).According to logistic regression analysis,the ratio of CD4^(+)/CD8^(+)in ascites and peripheral blood,anemia,APACHE Ⅱ score,and operation time≥3 hours were all risk factors o
作者
王玥
王伟
WANG Yue;WANG Wei(Operating Room of Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100050,China)
出处
《新疆医科大学学报》
CAS
2021年第1期70-75,共6页
Journal of Xinjiang Medical University
基金
中国博士后科学基金资助项目(2018T110121)。
关键词
结核性腹膜炎
肠梗阻
T淋巴细胞亚群
术后并发症
相关性分析
tuberculous peritonitis(TBP)
intestinal obstruction
T lymphocyte subsets
postoperative complications
correlation analysis
