体外循环手术前后病人血清sIL—2R水平和T淋巴细胞亚群,NK细胞的…

通过检测心脏体外循环手术前后病人血清中可溶性白介素２－受体、Ｔ细胞亚群、自然杀伤细胞，观察分析心脏ＣＰＢ手术病人细胞免疫的影响及其临床意义。选择：２４例风心病择期换瓣病人，术前，ＣＰＢ１０分钟、ＣＰＢ２小时，术后和１天、３天、５天检测血清ｓＩＬ－２Ｒ水平，Ｔ细胞亚群及ＮＫ细胞活性，术后第１天血清ｓＩＬ－２Ｒ水平升高，ＣＯ４（辅助细胞）活性明显降低，ＣＤ４／ＣＤ８（辅助细胞／抑制细胞）比值下降，ＮＫ     

直肠癌病人外周血NK细胞和T淋巴细胞亚群数目的变化及其临床意义

目的 探讨直肠癌病人外周血NK细胞和T淋巴细胞亚群的变化及临床意义。方法 分别应用同位素及流式细胞仪法检测26例正常人（无肿瘤）和35例直肠癌患者（包括术前术后）外周血NK细胞和T淋巴细胞亚群数目。结果 NK细胞,CD3,CD4,CD4／CD8比值在直肠癌组与对照组差异显著性（P＜0．05）。直肠癌患者随Dudes分期增高而NK细胞,CD3,CD4,CD4／CD8比值逐渐下降,差异均有极显著性（P＜0．01）。根治术和姑息性切除术后NK细胞CD3,CD4,CD4／CD8升高,CD8回落接近对照组。肿瘤未切除组术后NK细胞,CD3,CD4／CD8则进一步下降,差异有显著性（P＜0．05）。结论 直肠癌患者NK细胞等各项免疫指标大大降低,这种疫紊乱状态在不同病情又有显著差别,根治术和姑息性切除术可明显改善病人的免疫状态。     

围术期输血对T淋巴细胞亚群、NK细胞变化和血清sIL-2R水平变化的影响及临床意义

目的 探讨输入异体全血和盐水、腺嘌呤、葡萄糖、甘露醇处理后红细胞血（ＳＡＧ－Ｍ红细胞血）后,Ｔ淋巴细胞亚群,ＮＫ细胞数量和血甭可溶性白介素２受体（ｓＩＬ－２Ｒ）水平的变化,为临床合理输血提供实验依据。方法 直肠癌根治手术患者３０例,随机分为２ Ⅰ组（ｎ＝１５）术中输血这异体全血这异体,Ⅱ组（ｎ＝１５）术中输血为ＳＡＧ－Ｍ红细胞血,术中输血量均为４００ｍｌ。用间接免疫荧光法和双抗夹心ＥＬＩＳＡ法,检     

进展期胃癌病人NK细胞和T细胞亚群的变化

本文主要报道我科近年来对一组进展期胃癌病人检测其自然杀伤细胞(NK)活性和T细胞亚群变化,结果提示这类病人的NK活性和T细胞亚群中CD_3~ 、CD_4~ 细胞均明显低于正常值,而CD_8~ 细胞有增高,CD_4~ /CD_8~ 细胞比值减小。这一变化已引起临床医师的关注,并已用于开展对中、晚期胃癌病人手术、化疗前后全过程的免疫学检测。     

胃癌围手术期T细胞亚群和NK细胞活性检测的临床意义

目的 探讨胃癌围手术期细胞免疫功能的变化及与肿瘤分期的关系。方法 采用流式细胞仪测定40例胃癌患者围手术期外周血T淋巴细胞亚群和NK细胞活性。结果 胃癌患者术前外周血CD_3~+细胞、CD_4~+细胞、CD_4~+/CD_8~+比值和NK细胞活性明显低于正常对照组,CD_8~+细胞显著升高,并与病理分期相关,分期越晚改变越大。手术后以上指标可显著改善。结论 胃癌患者细胞免疫功能低下,病理分期越晚细胞免疫功能越低,肿瘤负荷是其主要原因。     

胰腺癌患者化疗前后外周血自然杀伤T细胞、T细胞亚群及γ干扰素等细胞因子的变化

目的：探讨胰腺癌患者化疗前后外周血中自然杀伤T细胞（NKT）、T淋巴细胞亚群及γ干扰素等细胞因子的变化及其意义。 方法：将确诊的42例胰腺癌实施化疗的患者作为胰腺癌组,另选30例消化内科收治的胰腺炎患者为胰腺炎组、30例体检健康人群为健康组,比较三组外周血中自然杀伤T细胞、T淋巴细胞亚群及γ干扰素等细胞因子水平差异。 结果：胰腺癌组在化疗前IFN-γ、肿瘤坏死因子ɑ（TNF-ɑ）、白细胞介素2（IL-2）水平分别显著的低于化疗后（P<0.05）;胰腺癌组患者化疗前的白细胞介素6（IL-6）显著的高于化疗后（P<0.05）;胰腺癌组患者化疗前、化疗后的IFN-γ、TNF-ɑ、IL-2水平均显著的低于健康组和胰腺炎组,胰腺癌组化疗前后IL-6水平均显著的高于健康组和胰腺炎组（均P<0.05）;胰腺癌组在化疗前NKT细胞显著的低于化疗后（P<0.05）;胰腺癌组患者化疗前、化疗后的NKT细胞均显著的低于健康组和胰腺炎组（P<0.05）;胰腺癌组患者在化疗前T淋巴细胞（CD3+、CD4+、CD4+/CD8+）水平均显著的低于化疗后（P<0.05）,胰腺癌组患者化疗前的CD8+显著的高于化疗后（P<0.05）。 结论：胰腺癌患者外周血免疫相关细胞及细胞因子水平较健康人群显著的降低,化疗后有助于改善患者的免疫水平、在化疗过程中检测免疫细胞及细胞因子变化可以对患者的化疗效果进行评价。     

布鲁菌病患者外周血NK细胞和T淋巴细胞亚群的变化

目的了解布鲁菌病患者性别、年龄、职业分布特征及并发症,外周血NK细胞和T淋巴细胞亚群的变化及意义。方法对101例布鲁菌病患者采用流行病学调查法进行调查,采用流式细胞仪抗体双表法检测38例布鲁菌病和非布鲁菌病发热患者外周血NK细胞（CD16^＋CD56^＋）、淋巴细胞绝对值（CD45^＋）、T淋巴细胞绝对值（CD3^＋）、T辅助细胞绝对值（CD3^＋CD4^＋）、T抑制/细胞毒细胞绝对值（CD3^＋CD8^＋）、B淋巴细胞绝对值（CD19^＋）、CD4/CD8比值,并进行分析。结果布鲁菌病患者以男性居多,中老年患者居多,发病人群主要为农牧民及从事防疫工作者,并发症以肝功能损害最多;布鲁菌病患者外周血NK绝对值显著低于非布鲁菌病发热患者组,具有统计学意义（t=-2.58,P〈0.05）。结论布鲁菌病以男性中老年患者居多,以农牧民和防疫员为主,布鲁菌病患者外周血NK细胞常受损伤。     

等容血液稀释自体输血对肿瘤病人围术期T淋巴细胞亚群、NK细胞影响的比较

目的：探讨异体输血和等容血液稀释自体输血对围术期T淋巴细胞亚群,NK细胞的变化。方法：选择直肠癌,结肠癌格或胃癌根治术病人30例,随机均分为2组。H组术中输异体全血400ml;A组于手术切皮前放血400ml,同时输入等量羟乙基淀粉。术中自体血回输给病人。分别于术前,输血前,术后第1d,第5d抽取静脉血,用流林细胞仪测定T细胞亚群和NK细胞的数量。结果：两组术后第1dCD3^ ,CD4^ ,CD4^ /CD8^ ,NK细胞较术前显著减少（P＜0．05或0．01）,异体输血组较自体输血组减少更明显（P＜0．05）。术后第5d异体输血组CD3^ ,CD4^ ,CD4^ /CD8^ ,NK细胞仍较术前显著减少,自体输血组基本恢复正常。结论：围术期输异体血严重抑制病人免疫,因液稀释自体输血免疫抑制轻微,且术后免疫功能很快恢复。     

肝癌患者外周血T细胞亚群NK活性及IL-2R表达的研究

分别对30例原发性肝癌及30例正常人进行外周血T细胞亚群、NK活性及lL-2R表达检测。结果:肝癌患者外周血CD_8细胞增高,CD_4细胞降低,CD_4/CD_6比值上升,NK活性减低及IL—2R表达阳性率降低。提示肝癌患者机体免疫功能较正常人明显降低。     

The regulation of natural killer cell activity by splenic nonspecific suppressor cells and its modification in cancer patients

Spleen cells (SC), splenic venous blood lymphocytes (SVL) and peripheral blood lymphocytes (PBL) from gastric and esophageal cancer patients were simultaneously tested for natural killer (NK) and nonspecific suppressor (Ts) cell activities. Furthermore, the influence of Ts activity on the augmentation of NK activity by a biological response modifier (BRM) was also investigated. Positive Ts activities were frequently detected in the SC, SVL and PBL of advanced cancer patients. The NK activities of SC and SVL were maintained even in advanced cancer patients, though significantly depressed NK activities were observed in the PBL of advanced cases. Cancer patient SC, SVL and PBL with positive Ts activity showed low NK activities. Moreover, the NK activities of SVL and PBL were low in the patients with positive Ts activity in SC. The NK activity of normal control PBL was strongly augmented by interleukin 2, interferon and OK-432. These BRMs exhibited comparable capacities to augment the NK activities of SC, SVL and PBL with negative Ts activity in cancer patients, however, the effects of these agents seemed to be low in cells with a positive Ts activity. These results suggested that NK activity might be regulated by nonspecific suppressor cells and the presence of suppressor cells might affect the augmentation of NK activity through BRM in circulating blood lymphocytes and also in spleen cells.     

IL－2基因修饰人骨肉瘤细胞的制备及骨肉瘤患者IL－2和sIL－2R测定

目的ＩＬ－２基因修饰人骨肉瘤细胞的制备及骨肉瘤患者ＩＬ－２、ｓＩＬ－２Ｒ水平测定。方法用逆转录病毒载体将人ＩＬ－２基因插入人骨肉瘤细胞系制备成ＩＬ－２基因修饰骨肉瘤细胞；用放射免疫法及ＥＬＩＳＡ法检测骨肉瘤患者血清内ＩＬ－２、ｓＩＬ－２Ｒ水平。结果经Ｇ４１８筛选和ＰＣＲ鉴定后制备成功人骨肉瘤ＩＬ－２基因修饰细胞，并证实其有分泌ＩＬ－２功能，用ＭＴＴ法测得其培养上清中ＩＬ－２表达量为每１ｘ１０５细胞２４小时５０－８００ｕ。骨肉瘤患者免疫功能调查发现其血清ＩＬ－２水平明显低于正常，而ｓＩＬ－２Ｒ则明显高于正常，术后两者可逐渐正常。结论　制备成功ＩＬ－２基因修饰骨肉瘤细胞并发现骨肉瘤患者ＩＬ－２水平低下，为进行骨肉瘤基因治疗创造条件。     

心内直视手术麻醉与体外循环期间血浆降钙素基因相关肽的变化

目的：研究麻醉、心内直视手术及体外循环期间降钙素基因相关肽（ＣＧＲＰ）的变化及其与前列环素代谢产物（６－ｋｅｔｏ－ＰＧＦ１α）变化的关系。探讨ＣＧＲＰ在心肌保护的意义。方法：应用放免法对１５例心内直视手术患者的血浆ＣＧＲＰ和６－ｋｅｔｏ－ＰＧＦ１α浓度分别在麻醉前、麻醉平稳后、转机前、转机中、转机后、术毕和术后第二天七个时间点进行动态观察。结果：（１）ＣＧＲＰ在转机中显著升高（Ｐ＜０．０５），转机后达峰值，并持续至术毕及术后第二天（上述均Ｐ＜０．０１）；（２）６－ｋｅｔｏ－ＰＧＦ１α在转机前及转机中显著升高，于转机后及术毕降低但仍显著高于基础值（上述均Ｐ＜０．０１）；（３）ＣＧＲＰ与６－ｋｅｔｏ－ＰＧＦ１α的变化规律不一致，两者无显著相关性（ｒ＝０．０１２，Ｐ＞０．０５）。结论：ＣＧＲＰ对体外循环期间的缺血，缺血后再灌注心肌细胞具有代偿性保护作用，这种作用与前列环素无明显关系。     

Changes in lymphocyte subsets, mitogen responsiveness, and interleukin-2 production after cardiac operations

We studied 104 patients after cardiac operations to search for changes in peripheral blood lymphocyte subsets, mitogen responsiveness, and interleukin-2 production. Mononuclear cells obtained from 10 patients with cholecystectomy were examined as control samples. Cultures for phytohemagglutinin and interleukin-2 production were incubated in microtiter plates for 24 hours with cells labeled with tritium thymidine used as target cells. Lymphocyte subsets were measured by using monoclonal antibodies. The results obtained with preoperative blood samples were compared with those from the first, third, and seventh days after operation. In patients having cardiac operations, mitogen responsiveness was low on both the first and the seventh days after operation and interleukin-2 production was markedly depressed (greater than 90% depressed) on the first postoperative day. However, in control samples from patients having cholecystectomy, lymphocyte subsets, mitogen responsiveness, and interleukin-2 production showed no significant changes. Improvement in interleukin-2 production occurred immediately in patients without blood transfusion from random donors and reached normal levels by postoperative day 3. However, interleukin-2 production remained depressed on day 3 in all patients with transfusion from random donors and remained significantly diminished even on day 7 in such patients in New York Heart Association classes III and IV. We conclude that heart operations for which cardiopulmonary bypass is used are associated with depression of cellular immunity, including interleukin-2 production. Furthermore, it appears that both blood transfusion from random donors and the general preoperative condition of the patients contribute to suppression of measures of cell-mediated immunity.     

Relation of suppressor activity to lymphocyte subsets,in vitro IL-2R expression,and biopsy results in cardiac transplant patients

Nonspecific suppressor activity of peripheral blood mononuclear cells (PBMC) was determined from 8 patients preoperatively and 22 patients subsequent to heart transplantation. Whereas no correlation was found between any defined lymphocyte subsets, in vitro interleukin-2 (IL-2) production, and IL-2R expression, or biopsy-proven rejection and suppressor cell activity when data obtained on the same day as the suppressor assay were analysed, the phytohemagglutinin — but not the concanavalin A induced, in vitro IL-2 production — was significantly enhanced (P < 0.02) in patients with evidence of concomitant rejection. In contrast, a significant correlation between diminished, nonspecific suppression and rejection was found when the results of biopsies performed up to 2 (P < 0.0075) and 4 (P < 0.0033) weeks after the investigation of suppressor cell activity were compared. We conclude that periodic determination of the suppressor functional status may be useful to discriminate between patients at low or high risk for graft rejection after heart transplantation.     

Kinetics of natural killer cell cytotoxicity during the graft-versus-host reaction. Relationship between natural killer cell activity, T and B cell activity, and development of histopathological alterations

The relationships between splenic natural killer (NK) cell cytotoxicity, T and B cell function, and the development of histopathological lesions in the liver and pancreas have been studied during the course of graft-versus-host (GVH) reactions. GVH reactions were induced in (C57BL/6 X A)F1 (B6AF1) hybrids by different doses, (10,20 and 30 X 10(6)) of either parental strain C57/BL6 (B6) or A lymphoid cells. Splenic NK cell cytotoxicity was studied by employing YAC-1, an NK-cell-sensitive target. Splenic T and B cell function were assessed by mitogen responsiveness to concanavalin A, phytohemagglutinin, and Escherichia coli lipopolysaccharide, and by the in vitro plaque-forming cell response to sheep red blood cells. Histopathological lesions characteristic of GVH reactions were recognized at a time (day 8 after GVH induction) when both T and B cell functions were totally suppressed and NK cell activity was greatest. The severity of histopathological alterations later (day 16 after GVH induction) correlated with an early peak in NK cell cytotoxicity rather than with the overall NK cell activity. When low doses (10,20 X 10(6)) of B6 cells were employed to induce GVH reactions, a significant increase in NK cell activity was observed, yet neither histopathological alterations nor suppression of T and B cell functions were observed. The killing of YAC-1 targets by splenocytes obtained from the different GVH combinations could not be abrogated by pretreatment with anti-Thy 1.2 serum plus complement, suggesting that T lymphocytes were not central to this cytolytic process. These experiments demonstrated that: (1) an inverse relationship between T and B cell function and NK cell activity was observed early after GVH induction, (2) the severity of histopathological lesions and immunosuppression, as well as the degree of overall augmented NK cell activity, was determined by the dose and genotype of donor cells injected to induce GVH reactions, and (3) GVH-associated moderate-severe lesions occurred only in groups in which NK cell activity peaked early--whereas when NK cell activity peaked later, either mild or no lesions were observed, suggesting that the early rapid increase of NK cell activity may be useful for predicting the severity of GVH pathogenesis.     

Performance may predict natural killer cell activity after an acute time‐limited stressor

Much attention has been given to natural killer cell activity (NKCA) in acute stressor research. While many studies show that acute stressors increase NKCA, fewer studies have investigated the variability in NKCA within an experimental group that is associated with performance. In his ‘Toughness’ theory of arousal, Richard Dienstbier suggests that behavioural performance during an acute stressor task could account for a variability in NKCA. We were not aware of any human studies that had investigated this possibility. Thus, in the present study we tested Dienstbier's proposal in a group of male and female human participants (n = 25) who completed a 4‐min serial subtraction mental arithmetic task. Blood samples were taken before and after the task. Controlling for baseline NKCA, performance score significantly predicted post‐task NKCA, β = 0.455, p = 0.01, and accounted for 25 per cent of the variance. Coincidence test showed no significant difference between men and women in predicting post‐task NKCA on performance score. Thus, in addition to evidence in the animal literature, the present study provides evidence that performance on an acute stressor is associated with enhanced NKCA in humans. Copyright © 2007 John Wiley & Sons, Ltd.