梗阻性黄疸内毒素血症与细胞免疫功能的关系

• 作 者: 张军 刘玉河 姜希宏 徐克森
• 机 构: 山东医科大学附属医院普外科
• 出 处: 华人消化杂志
• 发表日期: 1998年04期
• 关键词: 内毒素血症 血清内毒素 阻性 细胞免疫 免疫功能 胆管肿瘤 胰腺肿瘤 细胞亚群 胆总管结石 免疫学

目的研究梗阻性黄疸免疫功能及其与内毒素血症的相关性．方法检测２８例梗阻性黄疸患者及２０例健康对照者血清内毒素，Ｔ淋巴细胞亚群及血清ＳＩＬ２Ｒ的水平．结果梗阻性黄疸患者血清内毒素和ＳＩＬ２Ｒ水平较对照组明显升高（４７０ｎｇ／Ｌ±１１３ｎｇ／Ｌ和７２５ｋＵ／Ｌ±２０１ｋＵ／Ｌｖｓ２８４ｎｇ／Ｌ±１０３ｎｇ／Ｌ和３２４ｋＵ／Ｌ±１１６ｋＵ／Ｌ，Ｐ＜００１），Ｔ淋巴细胞亚群ＣＤ３，ＣＤ４，ＣＤ４／ＣＤ８明显降低（５０４％±３３％和２９９％±３８％ｖｓ６３８％±４４％和３８３％±２８％，Ｐ＜００１；１２２±０３２ｖｓ１４３±０３７，Ｐ＜００５），同时亦发现梗阻性黄疸内毒素血症组较非内毒素血症组ＣＤ３，ＣＤ４水平明显减低，ＳＩＬ２Ｒ水平明显升高（４７４％±５１％和２７６％±５２％和８６７ｋＵ／Ｌ±２３１ｋＵ／Ｌｖｓ５２３％±５２％和３１２％±４３％和６７４ｋＵ／Ｌ±１８９ｋＵ／Ｌ，Ｐ＜００５）．相关分析显示血清内毒素水平与血清ＳＩＬ２Ｒ水平呈显著正相关（ｒ＝０８５１７，Ｐ＜００１）．结论梗阻性黄疸时内毒素血症与免疫功能状态密切相关．

Objective To study the immune function of obstructive jaundice and its correlation with endotoxemia. Methods Serum endotoxin, T lymphocyte subsets and serum SIL2R were detected in 28 patients with obstructive jaundice and 20 healthy controls. Results Serum endotoxin and SIL2R levels in patients with obstructive jaundice were significantly higher than those in the control group (470ng / L ± 113ng / L and 725kU / L ± 201kU / Lvs284ng / L ± 103ng / L and 324kU / L ± 116kU / L, P <001). The levels of CD3, CD4 and CD4 / CD8 in T lymphocyte subsets were significantly decreased (504 ± 33% and 299 ± 38% vs 638 % ± 44% and 383% ± 28%, P <001; 122 ± 032vs143 ± 037, P <005), also found obstructive jaundice Compared with non-endotoxemia group, the levels of CD3 and CD4 in endotoxemia group were significantly decreased and SIL2R levels were significantly increased (474% ± 51%, 276% ± 52% and 867kU / L ± 231kU / Lvs 52.3% ± 52% and 312% ± 43% and 674kU / L ± 189 U / L, P <005). Correlation analysis showed that serum endotoxin level was positively correlated with serum SIL2R level (r = 08517, P <001). Conclusions Endotoxemia in obstructive jaundice is closely related to immune function.