AIM:To evaluate the effects of depression on parameters of cell-mediated immunity in patients with cancers of the digestive tract.METHODS:One hundred and eight adult patients of both sexes with cancers of the digestiv...AIM:To evaluate the effects of depression on parameters of cell-mediated immunity in patients with cancers of the digestive tract.METHODS:One hundred and eight adult patients of both sexes with cancers of the digestive tract admitted between March 2001 and February 2002 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. The Zung self-rating depression scale (SDS),Zung self-rating anxiety scale(SAS),numeric rating scale (NRS) and social support rating scale (SSRS) were employed to evaluate the degree of depression and their contributing factors.In terms of their SDS index scores,the patients were categorized into depression group (SDS≥50) and non-depression group(SDS<50).Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared between the two groups of patients.RESULTS:The SDS index was from 33.8 to 66.2 in the 108 cases,50% of these patients had a SDS index more than 50.Similarly,the SAS index of all the patients ranged from 35.0 to 62.0 and 46.3% of the cases had a SAS index above 50.Cubic curve estimation showed that the depression was positively correlated with anxiety and negatively with social support.Furthermore,the depression correlated with the tumor type,which manifested in a descending order as stomach,gallbladder, pancreas,intestine， esophagus,duodenum and rectum,according to their correlativity. Stepwise regression analysis suggested that hyposexuality,dispiritment,agitation,palpitation, low CD56 and anxiety were the significant factors contributing to depression.More severe anxiety (49.7±7.5 vs 45.3±6.9,P<0.05), pain (6.5±2.8 vs 4.6±3.2,P<0.05), poor social support (6.8±2.0vs 7.6±2.1,P<0.05),as well as decline of lymphocyte count (0.33±0.09vs 0.39±0.87, P<0.05) and CD56 (0.26±0.11 vs 0.29±0.11,P<0.05) were noted in the depression group compared with those of the non-depression patients. However,fewer obvious changes in CD4/展开更多
文摘目的探讨腹腔根治术对老年结直肠癌患者应激反应、炎症反应和细胞免疫功能的影响。方法选择118例结直肠癌患者,随机分为对照组59例与观察组59例。观察组行腹腔镜根治术,对照组行传统开腹术。比较两组围术期指标变化,术前和术后3 d应激反应、炎症反应和细胞免疫功能变化。结果观察组术中出血量明显少于对照组,术后排气时间明显快于对照组,并发症明显少于对照组(P<0.05);两组淋巴结清扫和手术时间比较无明显差异(P>0.05)。两组术后3 d血清肾上腺素(E)、皮质醇(Cor)和去甲肾上腺素(NE)水平较术前明显升高(观察组:t=8.268、17.191、10.543,对照组:t=20.122、27.313、24.014,均P<0.05);观察组术后3 d血清E、Cor和NE水平明显低于对照组(t=12.768、13.883、14.321,均P<0.05)。两组术后3 d血清白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α和C反应蛋白(CRP)水平较术前明显升高(观察组:t=7.866、8.338、9.667,对照组:t=20.491、16.652、16.144,均P<0.05);观察组术后3 d血清IL-6、TNF-α和CRP水平明显低于对照组(t=13.589、12.459、11.019,均P<0.05)。两组术后3 d CD3^+、CD4^+和CD4^+/CD8^+较术前明显降低(观察组:t=5.447、7.282、7.548,对照组:t=17.661、12.835、13.196,均P<0.05);观察组术后3 d CD3^+、CD4^+和CD4^+/CD8^+明显高于对照组(t=10.346、6.999、9.054,均P<0.05)。结论腹腔镜根治术对老年结直肠癌效果明显,且对应激反应、炎症反应和细胞免疫功能反应小。
基金Supported by the Natural Science Foundation of Shaanxi Province,No.99SM50
文摘AIM:To evaluate the effects of depression on parameters of cell-mediated immunity in patients with cancers of the digestive tract.METHODS:One hundred and eight adult patients of both sexes with cancers of the digestive tract admitted between March 2001 and February 2002 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. The Zung self-rating depression scale (SDS),Zung self-rating anxiety scale(SAS),numeric rating scale (NRS) and social support rating scale (SSRS) were employed to evaluate the degree of depression and their contributing factors.In terms of their SDS index scores,the patients were categorized into depression group (SDS≥50) and non-depression group(SDS<50).Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared between the two groups of patients.RESULTS:The SDS index was from 33.8 to 66.2 in the 108 cases,50% of these patients had a SDS index more than 50.Similarly,the SAS index of all the patients ranged from 35.0 to 62.0 and 46.3% of the cases had a SAS index above 50.Cubic curve estimation showed that the depression was positively correlated with anxiety and negatively with social support.Furthermore,the depression correlated with the tumor type,which manifested in a descending order as stomach,gallbladder, pancreas,intestine， esophagus,duodenum and rectum,according to their correlativity. Stepwise regression analysis suggested that hyposexuality,dispiritment,agitation,palpitation, low CD56 and anxiety were the significant factors contributing to depression.More severe anxiety (49.7±7.5 vs 45.3±6.9,P<0.05), pain (6.5±2.8 vs 4.6±3.2,P<0.05), poor social support (6.8±2.0vs 7.6±2.1,P<0.05),as well as decline of lymphocyte count (0.33±0.09vs 0.39±0.87, P<0.05) and CD56 (0.26±0.11 vs 0.29±0.11,P<0.05) were noted in the depression group compared with those of the non-depression patients. However,fewer obvious changes in CD4/
