经腹膜外盆腔淋巴间隙给药对妇科恶性肿瘤患者NTIL细胞的影响

目的 :探讨通过盆腔腹膜外淋巴间隙进行肿瘤生物治疗的可行性。方法 :妇科恶性肿瘤患者 4 1例分为IL 2组 (n =10 )、IL 2 + 5 FU组 (n =11)、5 FU组 (n =10 )及对照组 (n =10 ) ;通过经盆腔腹膜外淋巴间隙留置管 ,分别予以IL 2、IL 2 + 5 FU、5 FU治疗 ,在手术中摘取淋巴结 ,分离淋巴细胞 ,用流式细胞仪检测T细胞表面标记 ,CD2 5活化标记变化及NK细胞数量。结果 :治疗后各组淋巴结CD3+,CD4 +,CD8+,CD2 5 +,NK细胞数量均明显高于对照组 (P均 <0 .0 1) ;IL 2 + 5 FU组CD3+,CD4 +,CD8+,CD2 5 +及NK细胞含量均明显高于 5 FU组 (P <0 .0 5 ) ;IL 2组NK细胞含量明显高于 5 FU组 (P <0 .0 5 )。结论 :经盆腔腹膜外淋巴间隙进行生物治疗能有效激活机体局部淋巴结中T细胞反应 ,促进T细胞增殖及增加NK细胞数量     

子宫内膜异位症患者γδT细胞及NK细胞的功能分析

目的 :分析子宫内膜异位症患者中γδT细胞和天然杀伤 (NK)细胞功能的变化 ,并探讨患者腹腔液对正常人γδT细胞和NK细胞功能的影响。方法 :采用免疫荧光细胞检测及细胞毒活性检测法分析 2 2例子宫内膜异位症患者外周血、腹腔液中的γδT细胞及NK细胞的表型与功能。结果 :子宫内膜异位症 (疾病组 )患者外周血、腹腔液中CD56+细胞与正常对照组无明显差异 ,而疾病组腹腔液中γδ+T细胞分别高于外周血和正常对照组。疾病组腹腔液中的γδT细胞及NK细胞的功能低于外周血及正常对照组。疾病组的腹腔液对正常人外周血γδT细胞及NK细胞的功能具有负相调节作用。结论 :子宫内膜异位症患者的γδT细胞及NK细胞的功能低下 ,处于被抑制状态 ,提示子宫内膜异位症患者的腹腔中存在γδT细胞及NK细胞功能的抑制因子。     

盆腔子宫内膜异位症患者NK细胞表面自然细胞毒受体表达的研究

目的:探讨盆腔子宫内膜异位症患者外周血和腹腔液NK细胞表面自然细胞毒受体的表达及意义。方法:用流式细胞术直标法检测20例盆腔子宫内膜异位症患者和13例非子宫内膜异位症对照者外周血和腹腔液NK细胞表面自然细胞毒受体NKp30、NKp44和NKp46的表达。结果:(1)NKp30在腹腔液CD56+NK细胞表面表达观察组较对照组明显减少(P<0.05),在腹腔液CD16+NK细胞表面和外周血CD56+/CD16+NK细胞表面表达两组之间则无差异;NKp46在外周血和腹腔液CD56+/CD16+NK细胞表面表达观察组和对照组之间无显著差异;NKp44在外周血和腹腔液CD56+/CD16+NK细胞表面均无表达;(2)NKp30在腹腔液CD56+CD16+NK细胞上表达观察组比对照组明显减少;外周血CD56+CD16+NK细胞表面NKp30表达以及外周血和腹腔液CD56+CD16+NK细胞表面NKp46表达观察组和对照组之间则无差异;(3)NKp30和NKp46在腹腔液CD16+NK细胞表面表达较外周血显著降低(PNKp30<0.05;PNKp46<0.01),而CD56+NK细胞表面外周血和腹腔液之间的表达则无差异。结论:腹腔液NK细胞表面自然细胞毒受体NKp30在盆腔子宫内膜异位症发病过程中起作用。     

宫颈癌患者外周血HPV16抗原特异性CD8~+细胞毒性T细胞的检测及意义

目的:初步探讨人乳头瘤病毒16型(HPV16)阳性宫颈癌患者细胞免疫状况,了解其外周血抗原特异性CD8~+细胞毒性T细胞的水平.方法:采取免疫荧光标染重组MHC Ⅰ类分子-肽五聚体技术,运用流式细胞术定量检测患者和正常人外周血CD8~+细胞毒性T细胞、记忆性细胞毒性T细胞、活化细胞毒性T细胞及HPV16抗原特异性CD8~+细胞毒性T细胞.结果:宫颈癌患者CD8~+细胞毒性T细胞计数、记忆性细胞毒性T细胞计数、体内抗原特异性CD8~+细胞毒性T细胞计数和对照组比较差异无统计学意义,但活化细胞毒性T细胞计数低于对照组(P=0.322),体外经抗原肽刺激后抗原特异性CD8~+细胞毒性T细胞计数高于对照组(P=0.0068).结论:HPV16 阳性宫颈癌患者外周血中活化细胞毒性T细胞数目减少,表明患者细胞免疫功能受到一定的影响,通过抗原表位有效的诱导是提高患者的特异性细胞免疫功能的重要途径,运用五聚体技术检测宫颈癌患者抗原特异性细胞毒性T细胞,可初步反映患者特异性细胞免疫状态并有利于进行复发和预后分析.     

卵巢癌患者术后NDV-ATV-ASI与化疗对免疫功能的影响

目的 :评价新城鸡瘟病毒修饰的自体肿瘤细胞疫苗特异性主动免疫治疗(NDV ATV ASI)及化疗后患者免疫功能的变化 ,为实施肿瘤生物治疗 +化疗联合方案提供依据。方法 :卵巢癌患者术后 3 4例给予NDV ATV ASI及化疗 ,采用流式细胞术免疫荧光双标记法检测患者治疗后外周血单个核细胞 (PBMC)中CD4+ 、CD8+ 细胞内IFN γ和IL 4的表达 ;体外实验以NDV修饰的自体肿瘤细胞与PBMC共培养 (MLTC) ,观察其早期活化分子CD2 5、CD69的表达。结果 :治疗后CD4+ 、CD8+ T淋巴细胞内IFN γ的表达明显增高 ,IL 4表达轻度增高 ,且增高的时间较晚。外周血CD4+ 、CD8+ T淋巴细胞CD2 5、CD69的表达增加。单纯化疗组CD4+ 、CD8+ 细胞内IFN γ表达降低。结论 :NDV ATV ASI可诱导机体产生抗肿瘤免疫应答 ,检测单个T细胞水平的细胞因子可作为一种简单且可靠的免疫治疗效果评价参数 ;而化疗对机体的免疫功能有抑制作用 ,二者联合应用应选择适当的时间。     

有多次流产史妇女外周血CD56~+T细胞的比例下降

人类的CD56~+T细胞(CD3~+CD56~+细胞)表达NK细胞表面标志,包括外周血中单个核细胞(MNC)及肝脏中MNC。CD56~+T细胞包含CD4~-CD8~_的γδT细胞和αβT细胞,呈现出LGL的形态。这些特点表明人类CD56~+T细胞相当于小鼠的胸腺外T细胞,其显著特点是与NK细胞相似。近年研究表明有多次流产史者外周血中CD56~+细     

足月妊娠母胎界面与系统免疫中NK细胞表型和T细胞变化的研究

目的探讨足月妊娠母胎界面及系统免疫中NK、T细胞的免疫状态变化及其相互关系。方法对10例正常足月妊娠妇女,剖宫产同时采集子宫底蜕膜、外周静脉血,通过流式细胞技术,检测其NK细胞亚群、NK细胞表面受体CD69、CD94及Th1/Th2免疫状态。结果底蜕膜和外周血中各指标结果为:CD56brightCD16-含量:(18·72±17·73)%和(0·28±0·18)%;CD56+CD69+亚群:(34·98±19·79)%和(3·33±1·27)%;CD56brightCD94+含量:(15·94±13·19)%和(1·17±1·19)%;CD56+CD16-/CD56+CD16+比值:(2·30±2·25)和(0·34±0·28);CD56+CD69+/CD56+CD94+比值:(1·21±0·66)和(0·28±0·12),差异均有统计学意义(P<0·01);底蜕膜中Th1、Th2、Tc1细胞含量及Th1/Th2、Tc1/Tc2比值与外周血均无显著性差异(P>0·05);子宫底蜕膜中自然杀伤细胞(uterine natural killer cell,uNK细胞)亚群,uNK细胞表面受体CD69、CD94,Th1/Th2免疫状态与外周血均无相关性(P>0·05)。结论与维持妊娠免疫耐受关系极大的uNK细胞,在足月妊娠底蜕膜中保持相对的活化状态,同时uNK、T细胞的变化独立于外周血中的免疫状态。     

妊娠中晚期外周血T淋巴细胞亚群和NK细胞的观察

目的 :检测孕妇外周血T淋巴细胞亚群和NK细胞的变化 ,探讨正常妊娠时母体的细胞免疫状态。方法 :健康孕妇 92例按孕周分为 3组 :中孕组 (孕周 13～ 2 7+ 6周 )、晚孕未足月组 (孕周 2 8～ 36 + 6周 )和足月组 (孕周 37～ 4 1+ 6周 ) ;另取同期健康未孕生育年龄妇女 2 0例作对照组。用流式细胞仪检测其外周血T淋巴细胞亚群和NK细胞的相对数 ,结合外周血白细胞计数计算其绝对数。结果 :正常孕妇外周血白细胞总数显著增加 ,其中粒细胞百分数和绝对数均显著增加 ,单核细胞绝对数增加 ,淋巴细胞百分数和绝对数均显著减少 ;CD3+ 细胞百分数显著增加 ,CD4 + 细胞百分数和绝对数均显著减少 ,CD4 + /CD8+ 比值显著下降 ,CD8+ 细胞差异无显著性 ;NK细胞百分数和绝对数均显著减少。随着孕周进展 ,CD4 + 细胞百分数和绝对数均逐渐减少 ,CD4 + /CD8+ 比值逐渐下降 ,中孕组与晚孕未足月组比较 ,差异有显著性 (P <0 .0 5 )。结论 :妊娠期母体细胞免疫功能处于免疫抑制状态 ;随着妊娠进展 ,这种抑制有一定程度的下降。     

复发性自然流产患者外周血淋巴细胞Fas表达及其与NK细胞毒性的相关性研究

目的:探讨复发性自然流产(RSA)患者的外周血淋巴细胞Fas表达并分析NK细胞毒性与其Fas表达的相关性。方法:应用流式细胞仪技术检测25例RSA患者外周血淋巴细胞Fas表达及NK细胞毒性,对NK细胞Fas表达与其毒性进行相关性分析。结果:正常组表达Fas的CD4+T淋巴细胞为21.06%±4.36%,RSA组为18.27%±4.81%,两组比较无统计学差异(P>0.05)。RSA组表达Fas的CD8+T淋巴细胞为12.32%±2.78%,较正常组(7.78%±2.17%)高,差异有统计学意义(P<0.01)。RSA组表达Fas的NK细胞为14.23%±3.67%,较正常组(8.87%±2.95%)高,差异有统计学意义(P<0.01)。表达Fas的NK细胞含量与NK细胞毒性呈显著正相关。效应细胞:靶细胞为25:1时,相关系数r=0.693,(P<0.01)。效应细胞:靶细胞为50:1时,r=0.672(P<0.01)。结论:RSA患者存在CD8+T淋巴细胞和NK细胞的异常激活,外周血NK细胞毒性增高与表达Fas的NK细胞增多有关。     

原因不明复发性流产蜕膜CD4~+CD25~+CD127~(dim/-)Treg细胞对自然杀伤细胞的功能调控

目的探讨原因不明复发性流产(URSA)患者蜕膜CD4+CD25+CD127dim/-Treg细胞对自然杀伤(NK)细胞的功能调控。方法留取2007年2月至2009年2月上海交通大学医学院仁济医院5例URSA患者(URSA组)和5例正常早孕人流妇女(对照组)蜕膜组织,制备成单个核细胞悬液,用免疫磁珠分离法分离出CD4+CD25+CD127dim/-Treg细胞和NK细胞,将CD4+CD25+CD127dim/-Treg细胞和NK细胞共培养,用LDH释放实验测定共培养后NK细胞毒性变化,FCM法测定共培养后NK细胞胞内IFN-γ、穿孔素(perforin)产生情况。结果共培养后对照组和URSA组NK细胞的毒性均比单独纯化NK细胞的毒性明显降低(P=0.002,P=0.03),URSA组NK细胞毒性较对照组高(P0.001);对照组和URSA组NK细胞内细胞因子INF-γ、perforin的水平分别较单独纯化NK细胞内细胞因子水平明显降低[INF-γ(P=0.001,P=0.02);perforin(P=0.01,P=0.03)],URSA组NK细胞INF-γ、perforin的表达较对照组高(P0.001,P0.001)。结论 CD4+CD25+CD127dim/-Treg细胞对NK细胞功能有抑制作用;URSA中Treg细胞免疫抑制功能的下降,是NK细胞的活化异常和毒性增加的原因之一。     

妇科恶性肿瘤淋巴结转移的腹膜后与腹腔化学治疗的比较

目的 比较妇科恶性肿瘤患者淋巴结转移的腹膜后化学治疗（化疗）和腹腔化疗的疗效,并进一步评价腹膜后化疗。方法 选择６２例妇科恶性肿瘤患者,手术前分别随机进行腹膜后化疗４３例、腹腔化疗重复给药１１例和腹腔化疗单次注药（５氟嘧啶,５－ＦＵ）８例,采用高效液相色谱侧定法（ＨＰＬＣ）检测淋巴结内－５ＦＵ的浓度。其中１６例腹膜后化疗重复给药患者,比较注药侧与未注药侧淋巴结内５－ＦＵ的浓度。选择腹膜后化疗患者６     

盆腔腹膜外化疗法用于妇科恶性肿瘤淋巴系转移的初步研究

通过动物实验及临床研究，对经盆腔腹膜外间隙穿刺插管进行化疗的可行性及其对妇科恶性肿瘤淋巴系转移的疗效进行探讨。动物实验结果表明，于盆腔腹膜外间隙注入５－氟脲嘧啶（５－ＦＵ）及伊索显（Ｉｓｏｖｉｓｔ－３００）混合剂后，注药部位局部细胞形态无改变，仅有少量淋巴细胞浸润；临床观察结果表明，（１）注药后Ｘ线摄片，可见髂外、髂内、闭孔、腹股沟深及大部分髂总淋巴结所在位置均包括在药物分布范围之内，重复给药，药物分布范围不变；（２）注药后４８小时内，注药侧淋巴结内、ＦＵ浓度高于对照侧，差异有极显著性（Ｐ＜０．０１）。腹主动脉旁淋巴结内５－ＦＵ浓度介于注药侧与对照侧淋巴结内浓度之间；（３）对己有肿瘤细胞转移的淋巴结，注药后显微镜下可见淋巴结内转移的癌细胞有明显变性、坏死；（４）本组患者未发生并发症及明显的全身毒副作用，本研究结果提示，经盆腔腹膜外间隙化疗是一种简便、安全、效果可靠的化疗方法。     

Lymphocyte subset distribution and cytokine secretion in third trimester decidua in normal pregnancy and preeclampsia

BACKGROUND: Excessive Th1 activity in peripheral blood plays a probable role in the pathogenesis of preeclampsia. The aim of the study was to investigate whether disturbed local immune reactions are also present in decidua. METHODS: Flow cytometric analysis of CD3, CD19, CD56/CD16, CD4, CD8, CD4/CD29, CD4/CD45RA, CD4/CD45RO, CD8/CD28, CD3/CD69 lymphocyte subsets isolated from third trimester decidua of pregnants with preeclampsia (n=21) and pregnant controls (n=11) subjected to elective caesarean sections. Spontaneous and phytohemaglutynine stimulated "in vitro" secretion of IL-2, IL-4, IL-6, IL-10, IL-12, IFN-gamma and TGF-beta by decidual lymphocytes was studied by ELISA. For the statistical significance of differences between the groups the U Mann-Whitney test was performed (confidence interval P<0.05). RESULTS: Preeclamptic patients were characterized with an increased percentage of the CD3-/CD56+CD16+, CD8+/CD28+ and decreased percentage of CD3+, CD19+, CD4+/CD45RA+ lymphocytes. The profile of secreted cytokines shifts in favor of Th1 activity (extremely high IFN-gamma and low IL-6 and IL-10 secretion). Decidual IL-12 secretion in preeclamptic patients is decreased compared to controls. CONCLUSION: Changes in NK and T lymphocyte subsets followed with Th1 cytokine IFN-gamma over-activity, could affect local immunoregulatory mechanisms in third trimester decidua of preeclamptic patients.     

Phenotypic and functional analysis of tumor-infiltrating lymphocytes compared with tumor-associated lymphocytes from ascitic fluid and peripheral blood lymphocytes in patients with advanced ovarian cancer.

To investigate and compare the phenotype and function of lymphocytes collected from patients harboring advanced ovarian cancer, leukocytes from peripheral blood (n = 18), ascitic fluid (n = 13) and tumor tissues (n = 13) were evaluated for the relative proportions of lymphocyte subsets, including CD3+, CD4+, CD8+, CD19+, CD56 and the early (CD25) and late (HLA-DR) activation markers on CD3+ T cells. The ability to synthesize type 1 cytokines (IFN-gamma and IL-2) and a type 2 cytokine (IL-4) was assessed by flow cytometry. In all patients, T cells (CD3+) were the major leukocyte population detected in each tissue, with CD4+ T cells being dominant in peripheral blood lymphocytes (PBL) and tumor-associated lymphocytes (TAL) but not in tumor-infiltrating lymphocytes (TIL) (CD4:CD8 ratios: 3.0 vs. 2.0 vs. 1.0, respectively). CD19+ lymphocytes (B cells) and CD56+ lymphocytes (NK cells) were significantly higher in PBL compared to TAL and TIL (p < 0.05). TAL and TIL had a higher proportion of T cells expressing the late activation marker HLA-DR compared to PBL. In contrast, no significant differences were detected in PBL, TAL and TIL in the expression of the early activation marker CD25. Type 1 cytokines were the dominant type produced by in vitro stimulated T cells for each population, with a greater proportion of IFN-gamma+ T cells in TAL and TIL compared to PBL (p < 0.01), and a higher proportion of IL-2+ T cells in PBL compared with TAL and TIL (p < 0.05). Low percentages of IL-4+ T cells (i.e. Th2) were detected in each tissue. Taken together, these data demonstrate the recruitment and accumulation of high concentrations of antigen-experienced T lymphocytes in TAL and TIL compared to PBL. However, low surface expression of IL-2 receptor (i.e. CD25), as well as depressed intracellular IL-2 production in chronically stimulated TAL and TIL suggests that the impaired antitumor function commonly detected in these lymphocyte populations may be secondary to an acquired dysregulation of the IL-2 pathway.     

Chemotherapy for Lymphatic Metastatic Gynecologic Cancer via Pelvic Retroperitoneal Cannulation: A Preliminary Report

The feasibility of chemotherapy for lymphatic metastatic gynecologic cancer via pelvic retroperitoneal cannulation was preliminarily studied. In 25 patients with gynecologic cancer 5-FU was safely allocated by cannulation to the pelvic retroperitoneal space including the external iliac, internal iliac, obturator, and deep inguinal and most of the common iliac lymph nodes. The 5-FU concentration in the lymph nodes on the injection side was 2–10 times that on the control side (P< 0.01). In 4 patients with nodal metastasis on the injection side, most cancer cells showed degeneration and necrosis. No severe complications or adverse effects were observed. The results suggested that the cannulation be used to treat the lymphatic metastasis of gynecologic cancer.     

Transplantation of CD34 human cells into mice with severe combined immunodeficiency results in functional T cells 4 weeks after transplantation.

OBJECTIVE: Our purpose was to determine whether transplantation of fetal human CD34(+) cells into mice with severe combined immunodeficiency results in functional T cells. STUDY DESIGN: The cells used in this study were isolated from fetal human liver tissue obtained after elective termination of normal 18- to 24-week pregnancies. Women with medical conditions that could confound the outcome were excluded. Cells were labeled with fluorochrome-conjugated antibodies that recognized CD34 or other cell surface antigens. The cells were then sorted with the use of a fluorescein-activated cell sorter. The human sorted cells were injected intraperitoneally in mice with severe combined immunodeficiency. Four groups of mice were studied: group 1, injected with 10(5) CD34(+) cells (n = 17); group 2, injected with 10(5) CD34(-) cells (n = 14); group 3, injected with 10(6) unsorted cells (n = 19); and group 4, sham-injected with phosphate-buffered saline solution as controls (n = 14). At 1, 2, and 4 weeks after transplantation, the peripheral blood monocytes of the study mice were analyzed for functional T cells. Aliquots of cells (10(5)) were incubated for 48 hours with 0, 5, 10, and 20 micrograms of phytohemagglutinin. Thereafter the cells were treated with 1 microCi of tritiated thymidine. Subsequently the incorporation of tritiated thymidine was determined by liquid scintillation counting. RESULTS: Cells from mice transplanted with either unsorted cells, sorted CD34(+) cells, or CD34(-) cells showed a response to phytohemagglutinin that varied with time and with the mitogen concentration. Even though unsorted fetal human liver cells had a maximal response at 2 weeks, this posttransplantation response was not statistically significant. CD34(+) cell response to phytohemagglutinin was significant at 4 weeks after transplantation. CD34(-) cells also had a peripheral blood cell response at 4 weeks after transplantation; however, this response was not statistically significant. In addition, all mice transplanted with fetal human liver cells had some functional T cells at 4 weeks; however, this response was statistically significant only for CD34(+) cells. CONCLUSION: Transplantation of either sorted CD34 (positive or negative) cells or unsorted fetal human liver cell preparations into mice with severe combined immunodeficiency results in functional T cells. However, only the mice with transplanted CD34(+) cells demonstrated a statistically significant response.     

腹腔镜手术治疗盆腔炎性包块对T细胞免疫功能及术后恢复的影响

目的 探讨腹腔镜与开腹手术治疗盆腔炎性包块对机体细胞免疫功能及术后恢复时间的影响并探讨其间的关系。方法　2008年1月至2011年12月在青岛市妇女儿童医院取56例盆腔炎包块手术患者术前、术后2h、术后24h和术后72h的静脉血标本［腹腔镜手术组32例(腹腔镜组)和开腹手术24例(开腹组)］。流式细胞术(flow cytometry, FCM)测定T细胞亚群CD3+、CD4+和CD8+,对两组各指标的测定值进行比较,同时测定Th1、Th2细胞数量,统计两组之间各亚群以及Th1、Th2和、Th1/ Th2 比值的差异。酶标法(ELISA)测定血清白介素（IL）-18、IL-10水平,统计两组之间的差异。术后恢复情况：排气时间、体温恢复到正常时间、血象恢复时间、住院时间等。结果　腹腔镜组T淋巴细胞亚群手术前后差异均无统计学意义;开腹组术后24 h时CD3+、CD4+、CD8+与术前比较均明显降低,术后72 h时有所回升,但仍低于术前水平;两组比较,开腹组术后CD3+、 CD4+、 CD8+降低更为明显;两组术后2h均出现Th1/Th2细胞平衡向Th2反应转换,Th1细胞、Th1/Th2比值、IL-18下降（腹腔镜组: t=2.238, P＜0.05; t=7.15,P＜0.01;t=6.98,P＜0.01;开腹组: t=9.45,P＜0.01;t=8.56,P＜0.01;t=10.17,P＜0.01）,而Th2细胞、抗炎因子IL-10上升（腹腔镜组: t=7.35,P＜0.01;t=8.87,P＜0.01;开腹组: t=6.53,P＜0.01;t=7.18,P＜0.01）。但腹腔镜组术后24hTh1、Th2 细胞数、Th1/Th2 比值、IL-18、IL-10各项指标即恢复(t=1.82,P>0.05; t=1.38, P>0.05; t=1.72, P>0.05; t=1.78,P>0.05; t=1.89, P>0.05),而开腹组24h各项指标的变化与术后2h类似,并持续至术后48h。结论　盆腔炎性疾病手术后细胞免疫功能紊乱可能参与术后的恢复。腹腔镜下盆腔炎性包块切除术组T细胞亚群影响程度小,且Th1/Th2细胞平衡恢复快,对机体的细胞免疫影响小,术后恢复快。     

腹腔镜手术治疗盆腔炎性包块对T细胞免疫功能及术后恢复的影响

目的 探讨腹腔镜与开腹手术治疗盆腔炎性包块对机体细胞免疫功能及术后恢复时间的影响并探讨其间的关系。方法　2008年1月至2011年12月在青岛市妇女儿童医院取56例盆腔炎包块手术患者术前、术后2h、术后24h和术后72h的静脉血标本［腹腔镜手术组32例(腹腔镜组)和开腹手术24例(开腹组)］。流式细胞术(flow cytometry, FCM)测定T细胞亚群CD3+、CD4+和CD8+,对两组各指标的测定值进行比较,同时测定Th1、Th2细胞数量,统计两组之间各亚群以及Th1、Th2和、Th1/ Th2 比值的差异。酶标法(ELISA)测定血清白介素（IL）-18、IL-10水平,统计两组之间的差异。术后恢复情况：排气时间、体温恢复到正常时间、血象恢复时间、住院时间等。结果　腹腔镜组T淋巴细胞亚群手术前后差异均无统计学意义;开腹组术后24 h时CD3+、CD4+、CD8+与术前比较均明显降低,术后72 h时有所回升,但仍低于术前水平;两组比较,开腹组术后CD3+、 CD4+、 CD8+降低更为明显;两组术后2h均出现Th1/Th2细胞平衡向Th2反应转换,Th1细胞、Th1/Th2比值、IL-18下降（腹腔镜组: t=2.238, P＜0.05; t=7.15,P＜0.01;t=6.98,P＜0.01;开腹组: t=9.45,P＜0.01;t=8.56,P＜0.01;t=10.17,P＜0.01）,而Th2细胞、抗炎因子IL-10上升（腹腔镜组: t=7.35,P＜0.01;t=8.87,P＜0.01;开腹组: t=6.53,P＜0.01;t=7.18,P＜0.01）。但腹腔镜组术后24hTh1、Th2 细胞数、Th1/Th2 比值、IL-18、IL-10各项指标即恢复(t=1.82,P>0.05; t=1.38, P>0.05; t=1.72, P>0.05; t=1.78,P>0.05; t=1.89, P>0.05),而开腹组24h各项指标的变化与术后2h类似,并持续至术后48h。结论　盆腔炎性疾病手术后细胞免疫功能紊乱可能参与术后的恢复。腹腔镜下盆腔炎性包块切除术组T细胞亚群影响程度小,且Th1/Th2细胞平衡恢复快,对机体的细胞免疫影响小,术后恢复快。