腹腔镜卵巢良性肿瘤切除手术对患者免疫功能的影响

[目的]研究腹腔镜卵巢良性肿瘤手术对机体Th1／Th2、共刺激分子平衡的影响。[方法]选择2007年9月～2008年9月卵巢良性肿瘤患者60例．分为腹腔镜组30例．开腹手术组30例。比较两组围手术期白细胞介素4（IL-4）、γ干扰素（IFN-γ）的水平和CD28、CTLA-4的表达。[结果]开腹组术后IL4水平和CTLA-4的表达明显升高，分别在术后24h（35．41±3．66pg／ml）和术后48h（4．02％±0．85％）最高；而IFN-γ水平和CD28表达下降均在术后6h最低（1．36±0．27pg／ml，40．24％±3．78％）。腹腔镜组术后各指标均无明显变化：两组间有显著性差异（P〈0．05）。[结论]腹腔镜手术对Th1/Th2、共刺激分子平衡无显著影响，对机体免疫功能影响小。

Effect of laparoscopic Surgery on Immunity in Patients with Benign Ovarian Tumor

[Purpose ] To investigate the effect of laparoscopic surgery for benign ovarian tumor on the balance of Th1 and Th2 cell, costimulatory molecules. [Methods]Sixty patients with benign ovarian tumor from Sept. 2007 to Sept.2008 were studied. Of them 30 cases underwent laparoscopic operation and 30 cases open laparotomy. The serum level of IL-4, IFN-γ and the expression of CD28, CTLA-4 in perioperation stage in the 2 groups were compared. [Results] The serum level of IL-4 and expression of CTLA-4 in open laparotomy group increased significantly postoperation, with a peak in 24h（35.41 ±3.66pg/ml） and 48h postoperation（4.02%±0.85%） respectively; while IFN-γ and CD28 both decreased postoperation, with a lowest level at 6h postoperation（1.36± 0.27ph/ml and 40.24%±3.78% respectively）. These parameters had no significant change in laparoseopie group postoperation, hut those with significant difference between the two groups （P〈 0.05）. [Conclusions] Laparoscopy has Jess effect to the balance of Th1 and Th2 Cell, Costimulatory molecules, and has fewer influence on immunity.