急性胰腺炎对免疫功能的影响

目的研究急性胰腺炎发病及治愈后患者的免疫功能变化。方法检测31例急性胰腺炎患者发病后和治愈后T细胞亚群、IgA、IgM、IgG抗体和补体C3、C4，进行前后对比分析并与正常对照组对比分析。结果急性胰腺炎发病后其T淋巴细胞亚群中总T细胞、CD4^＋细胞和CD4^＋／CD8^＋比值均下降；血清IgA、IgG、IgM、补体C3、C4水平有不同程度的下降，其中以重症急性胰腺炎最明显；随着疾病的治愈，机体免疫功能逐步恢复，上述免疫学指标也大都能恢复到正常水平。结论急性胰腺炎患者存在不同程度的免疫功能损害，尤其以重症急性胰腺炎明显，其与疾病的发展和转归相互影响、相互作用，在急性胰腺炎的治疗中应重视免疫功能的变化。     

急性胰腺炎对免疫功能的影响

目的研究急性胰腺炎发病及治愈后患者的免疫功能变化.方法检测31例急性胰腺炎患者发病后和治愈后T细胞亚群、IgA、IgM、IgG抗体和补体C3、C4,进行前后对比分析并与正常对照组对比分析.结果急性胰腺炎发病后其T淋巴细胞亚群中总T细胞、CD4+细胞和CD4+/CD8+比值均下降;血清IgA、IgG、IgM、补体C3、C4水平有不同程度的下降,其中以重症急性胰腺炎最明显;随着疾病的治愈,机体免疫功能逐步恢复,上述免疫学指标也大都能恢复到正常水平.结论急性胰腺炎患者存在不同程度的免疫功能损害,尤其以重症急性胰腺炎明显,其与疾病的发展和转归相互影响、相互作用,在急性胰腺炎的治疗中应重视免疫功能的变化.     

ASCI患者外周血T淋巴细胞亚群及Th1、Th2型细胞因子的动态变化与意义

目的探讨急性脊髓损伤（ASCI）患者外周血T淋巴细胞亚群及Th1、Th2型细胞因子的动态变化及临床价值。方法对26例ASCI患者用流式细胞仪检测T淋巴细胞亚群表达情况，用酶联免疫吸附测定法（ELISA）测定其血清因子IL-2、IFN-γ、IL-4、IL-6水平并与正常人进行对照。结果T淋巴细胞亚群CD^＋4及CD^＋4／CD^＋8在伤后1d、3d、1周、2周均显著降低，CD^＋8无明显变化；IL-2、IFN-γ在伤后1d,3d、1周、2周均显著降低，IL-4、IL-6在伤后1d、3d、1周、2周均显著升高（P均〈0．05）。结论ASCI患者CD4＋细胞明显降低，CD^＋4／CD^＋8倒置：Th1、Th2细胞功能明显偏移，Th2细胞功能亢进，Th1细胞功能降低。免疫干预有望成为治疗ASCI的新途径。     

脓毒症患者前白蛋白的变化及其临床意义

目的观察重症监护室（intensive care unit，ICU）脓毒症（sepsis）患者的前白蛋白（prealbumin，PA）的变化，分析其与免疫功能、疾病严重程度以及死亡率的关系。方法对收治ICU的15例Sepsis患者进行全肠外营养（total parenteral nutrition，TPN），观察Sepsis患者TPN前后PA、白蛋白、T淋巴细胞亚群、NK细胞、免疫球蛋白的变化，分析PA与白蛋白、T淋巴细胞亚群、NK细胞、免疫球蛋白以及预后的关系。结果收治15例Sepsis患者中PA均明显下降；但T细胞亚群下降不明显，免疫球蛋白中补体C3、补体C4有下降，其余下降不明显。结论血清PA的检测可能是预测Sepsis患者疾病严重程度以及死亡率的敏感性指标。     

复发性口腔溃疡患者外周血T淋巴细胞亚群的变化及意义

目的探讨T淋巴细胞亚群在复发性口腔溃疡（ROU）患者外周血中的变化及其对ROU发病的影响。方法用流式细胞仪检测55例ROU患者（观察组）与48例健康人（对照组）外周血T淋巴细胞亚群。结果与对照组相比,观察组外周血中CD^4＋细胞及CD^4＋/CD^8＋均明显低于对照组、CD^8＋细胞明显高于对照组（P均〈0.05）。结论ROU的发生可能与患者细胞免疫功能紊乱及T淋巴细胞亚群的失衡有关。     

急性脑血管病患者T淋巴细胞亚群变化的研究

目的探讨急性脑血管病患者T淋巴细胞亚群的变化及临床意义。方法采集74例脑血管病人（38例脑梗死，36例脑出血）和30例健康人外周血，通过抗凝，标记，溶血加入PBS振荡上EPICS流式细胞仪直接检测T淋巴细胞亚群并进行相关分析。结果脑梗死、脑出血患者急性期（1W内）T淋巴细胞亚群CD3^＋、CD4^＋、CD4^＋／CD8^＋较正常对照组明显下降，不同损伤部位对细胞免疫功能影响为基底节区〉脑干〉额叶〉顶叶〉颞叶〉小脑〉枕叶，且出血量或梗死面积越大免疫功能下降越显著。结论脑梗死、脑出血患者发病后存在严重T细胞免疫功能低下．病变性质（梗死或出血）不是决定性因素，而可能取决于脑损伤的部位和程度。脑血管病人急性期提高其免疫功能对治疗及预后都有重要临床意义。     

全麻及硬膜外麻醉对肾癌根治术患者细胞免疫功能的影响

60例择期行肾癌根治术的女性患者,随机分为全麻醉组和硬外麻组,各30例。分别于麻醉前、术后1h及术后1、3 d用流式细胞仪检测患者外周血T淋巴细胞亚群和NK细胞。结果显示,术后1 h,两组CD^3＋、CD^4＋、CD^4＋/CD^8＋和CD56^＋下降,与麻醉前比较P〈0.05;术后1 d,CD^3＋、CD^4＋、CD^4＋/CD^8＋和CD56^＋均明显下降,与麻醉前比较P〈0.05。组间比较,P〈0.05。术后3 d,两组各项指标均恢复至麻醉前水平。认为不同麻醉方法抑制手术应激反应程度不同,硬外麻醉有利于减轻肾癌根治术患者手术应激反应,保护患者围术期细胞免疫功能。     

淋巴细胞亚群和细胞因子在Graves病患者外周血中的漂移特征

目的观察分析外周血淋巴细胞亚群及细胞因子的变化在Graves病（GD）发生发展中的临床意义。方法分别检测GDa组（初诊）、GDb组（治疗后）、GDe组（复发）和正常组外周血中淋巴细胞亚群、IL-12、IL-10的表达。结果与对照组相比，GDa组和GDc组CD^＋8、CD^＋3及CD^＋16淋巴细胞显著下降（P〈0.01），CD^＋4／CD^＋8比值和CD^＋19；明显升高（P〈0.01）；GDa组的IL-10、IL-12均高于对照组（P〈0.05）；GDb组的IL-12和IL-12／IL-10较GDa组显著降低（P〈0.05）；GDa和GDc组的CD^＋16与CD^＋8呈明显正相关（P〈0.05），与CD^＋19呈明显负相关（P〈0.01）。结论GD患者淋巴细胞亚群的分布特征和Thl／Th2的平衡紊乱在GD的发生发展过程中有着重要临床意义。     

血清补体含量在慢性再生障碍性贫血患者免疫发病机制中的意义

目的：探讨血清补体含量在慢性再生障碍性贫血（CAA）患者免疫发病机制中的意义。方法：采用免疫比浊法和流式细胞仪分析技术，观察60例CAA患者血清补体C3、C4和免疫球蛋白（Ig）含量，并分析血清C3含量与外周血T细胞亚群表达水平的相关性。结果：CAA患者血清C3、C4和Ig含量均较健康对照组降低；且血清C3含量与外周血CD8^＋细胞表达成正相关（r=0．30，P〈0．05），与CD4／CD8比值负相关（r=-0．31，P〈0．05），但与CD8^＋HLA-DR^＋细胞表达无关。结论：CAA患者血清补体含量与其B细胞功能和CD8^＋T细胞的免疫应答水平相关，其降低可能与机体本身的免疫保护机制有关。     

AECOPD患者的免疫功能分析

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者细胞免疫和体液免疫功能的变化。方法收集住院AECOPD患者29例,以正常健康人25例为对照组,测定他们外周血T淋巴细胞亚群、NK细胞、B淋巴细胞水平、IgA、IgG、IgM以及补体C3、C4。结果 (1)AECOPD组与对照组比较,B淋巴细胞水平下降(P0.05),活化T细胞水平显著升高(P0.01);(2)AECOPD组与对照组免疫球蛋白、补体水平无明显变化(P0.05)。结论 AECOPD患者存在免疫功能异常。活化T细胞显著升高,B淋巴细胞数降低,但功能未见下降,或有活跃。     

大剂量维生素C对急性胰腺炎患者细胞免疫功能的影响

背景：急性胰腺炎（AP）患者存在细胞免疫功能改变和血浆维生素C（Vti C)含量降低，Vit C具有抗氧化和提高机体免疫力的作用。目的：观察大剂量Vit C对AP患者细胞免疫功能的影响。方法：将84例AP患者随机分为治疗组和对照组，40例健康志愿者作为正常对照。治疗组予Vit C 10g稀释于5％葡萄糖500ml中静脉滴注，每日1次，连用5天；对照组予Vit C1g稀释于5％葡萄糖500ml中静脉滴注，每日1次，连用5天。观察正常对照组和两组患者治疗前后血浆Vit C含量和T淋巴细胞亚群的变化。结果：AP患者CD3和CD4阳性细胞百分比较正常对照组明显下降，其中重症急性胰腺炎（SAP）组的CD4阳性细胞百分比和CD4／CD8比值较轻症急性胰腺炎（MAP）组下降更为明显（P＜0．05）。大剂量Vit C治疗后，治疗组SAP患者的CD4阳性细胞百分比和CD4／CD8比值较对照组明显升高（P＜0．05）。结论：AP患者，特别是SAP患者存在细胞免疫功能损害，静脉输入大剂量Vit C对改善SAP患者的细胞免疫功能有一定作用。     

Early activation of peripheral lymphocytes in human acute pancreatitis

BACKGROUND: The CD69 antigen is an indicator of early lymphocyte activation. GOALS: To evaluate the early activation of peripheral lymphocytes T, B, and NK in patients with acute pancreatitis in comparison with patients with acute abdomen of nonpancreatic origin. STUDY: Thirty patients with acute pancreatitis were studied; 20 of them had the mild form of the disease and 10 had the severe form. Thirty patients with nonpancreatic acute abdomen were used as controls. All patients were enrolled within 48 hours of the onset of pain. In all patients, leukocytes and total lymphocyte and lymphocyte subset counts (CD4+, CD8+, CD56+, CD19+, CD4+CD69+, CD8+CD69+, CD56+CD69+, CD19+CD69+) were determined upon hospital admission. RESULTS: The percentage of total lymphocytes was significantly lower in acute pancreatitis patients than in those with nonpancreatic acute abdomen (P = 0.014); patients with severe pancreatitis had a percentage of total lymphocytes significantly lower when compared with patients with mild pancreatitis (P < 0.001). The CD19+CD69+ count was significantly lower in patients with severe pancreatitis (24.6 +/- 14.6%) than in patients with mild pancreatitis (46.7 +/- 16.5%; = 0.006). The counts of the other lymphocyte subsets were not statistically different between patients with acute pancreatitis and those with nonpancreatic acute abdomen, as well as between patients with mild and severe acute pancreatitis. CONCLUSIONS: Patients with severe pancreatitis show impaired early activation of peripheral CD19+ cells.     

重症急性胰腺炎Fas/FasL介导的胰腺细胞凋亡与Th1/Th2偏移的临床研究

[目的]观察重症急性胰腺炎Fas/FasL介导的胰腺细胞凋亡与Th1/Th2偏移的关系.[方法]将2012～2013年来我院治疗的急性胰腺炎患者40例分为重症胰腺炎（SAP）组和轻症胰腺炎（MAP）组,各20例.同时选取同时期来我院进行体检的健康人40例作为对照组,检测3组入院第1天以及观察组第3、5、7、10天患者血清中CD4＋T细胞计数、CD4＋细胞/CD8＋细胞、aFas、SCD4、IL-4、IFN-γ、IL-2、IL-10、IL-2/IL-10的变化.[结果]CD4＋T细胞的减少与胰腺炎的严重程度有关,胰腺炎sCD4与sFas浓度之间存在明显相关性.SAP组和MAP组中IL-4、IL-10水平均较对照组明显升高,胰腺炎IL-4、IFN-γ浓度与胰腺炎严重程度存在明显相关性.[结论]Th1/Th2细胞免疫漂移与急性胰腺炎有关,胰腺炎早期炎症反应占优势,之后抗炎反应占优势,与临床上急性胰腺炎发病过程相符,对于临床治疗胰腺炎有一定指导意义.     

慢性乙型重型肝炎免疫学指标分析

目的探讨慢性乙型重型肝炎免疫学指标变化的规律及其与近期疗效的关系。方法对65例慢性乙型重型肝炎和15例健康体检人群分别采用流式细胞仪、快速免疫消浊比浊法进行外周血T淋巴细胞亚群、IgG、总补体溶血活性CH50（CH50）、补体C3（C3）的检测。结果慢性乙型重型肝炎CD3＋、CD4＋T淋巴细胞计数均低于正常组,晚期低于早、中期（P〈0．05）,CD4＋／CD8＋比值高于正常组,晚期高于早、中期（P〈0．05）。IgG明显高于正常组,且晚期较早、中期进一步升高（P〈0．05）,CH50、C3低于正常组,晚期低于早期（P〈0．05）。结论慢性乙型重型肝炎患者存在免疫功能紊乱,可能存在细胞免疫功能低下与体液免疫功能亢进,随着疾病进展其有加重趋势。     

Adjuvant treatment of severe acute pancreatitis with C1 esterase inhibitor concentrate after haematopoietic stem cell transplantation

BACKGROUND: With an incidence of 4%, acute pancreatitis is a common complication of bone marrow or peripheral haematopoietic stem cell transplantation, which contributes significantly to morbidity and mortality in these patients. In most cases, the pathogenesis of acute pancreatitis cannot be attributed to a single pathogenetic factor, as treatment toxicity, acute graft versus host disease, infection, and cholestasis may all contribute. Acute pancreatitis is characterised by inflammation and activation of digestive proenzymes leading to autodigestive destruction of the pancreas and systemic activation of protease cascades including the complement system. AIM: To describe the effects of human C1 esterase inhibitor in two children, who developed severe acute pancreatitis with considerable complement activation after allogeneic haematopoietic stem cell transplantation. METHODS: Both children showed clinical features resembling those observed in capillary leakage syndrome. In both patients, treatment with C1 esterase inhibitor concentrate contributed to a rapid clinical stabilisation. CONCLUSIONS: These observations strongly support the proposed pathophysiological concept that early treatment with C1 esterase inhibitor interferes with the activation of the complement system in acute pancreatitis. Inhibition of complement activation prevents its adverse effects on vascular function and permeability, and thus stabilises intravascular fluid status and prevents multiorgan failure in acute pancreatitis.     

Therapeutic efficacy of high-dose vitamin C on acute pancreatitis and its potential mechanisms

AIM: To observe the therapeutic efficacy of high-dose Vitamin C 0/it. C) on acute pancreaUtis (AP), and to explore its potential mechanisms. METHODS: Eghty-four AP patients were divided into treatment group and control group, 40 healthy subjects were taken as a normal group, In the treatment group, Vit. C (10 g/day) was given intravenously for 5 days, whereas in the control group, Vit. C (1 g/day) was given intravenously for 5 days. Symptoms, physical signs, duration of hospitalization, complications and mortality rate were monitored. Meanwhile, serum amylase, urine amylase and leukocyte counts were also determined. The concentration of plasma vitamin C (P-VC), plasma lipid peroxide (P-LPO), plasma vitamin E (P-VE), plasma β-carotene (P-β-CAR), whole blood glutathione (WB-GSH) and the activity of erythrocyte surperoxide dimutase (E-SOD) and erythrocyte catalase (E-CAT) as well as T lymphocyte phenotype were measured by spectrophotometry in the normal group and before and after treatment with Vit. C in the treatment and the control group. RESULTS: Compared with the normal group, the average values of P-VC, P-VE, P-β-CAR, WB-GSH and the activity of E-SOD and E-CAT in AP patients were significantly decreased and the average value of P-LPO was significantly increased, especially in severe acute pancreatitis (SAP) patients (P&lt;0.05. P-VC, P=0.045; P-VE, P=0.038; P=0.041;P-β-CAR, P=0.046; WB-GSH, P=0.039; E-SOD, P=0.019;E-CAT, P=0.020; P-LPO, P=0.038). Compared with the normal group, CD3 and CD4 positive cells in AP patients were significantly decreased. The ratio of CD4/CD8 and CD4 positive cells were decreased, especially in SAP patients (P&lt;0.05. CD4/CDs, P=0.041; CD4, P =0.019). Fever and vomiting disappeared, and leukocyte counts and amylase in urine and blood become normal quicker in the treatment group than in the control group. Moreover, patients in treatment group also had a higher cure rate, a lower complication rate and a shorter in-ward days compared with those in he control group. After treatment, the average value of P-VC was significantly higher and the values of SIL-2R, TNF-α, IL-6 and IL-8 were significantly lower in the treatment group than in the control group (P&lt;0.05 P-VC, P=0.045; SIL-2R, P=0.012; TNF-α, P=0.030; IL-6, P=0.015,and IL-8, P=0.043). In addition, the ratio of CDJCD8 and CD4 positive cells in the patients of treatment group were significantly higher than that of the control group after treatment (P&lt;0.05. CD4/CDs, P =0.039; CD4, P=0.024). CONCLUSION: High-dose vitamin C has therapeutic efficacy on acute pancreatitis. The potential mechanisms include promotion of anti-oxidizing ability of AP patients, blocking of lipid peroxidation in the plasma and improvement of cellular immune function.     

清下化瘀方对急性胰腺炎胃肠道及免疫功能的保护作用

[目的]：评价清下化瘀方配合常规西药治疗对急性胰腺炎的胃肠道及免疫功能的保护作用.[方法]将65例急性胰腺炎患者分为治疗组32例、对照组33例.其中,对照组给予西药常规治疗,治疗组在西药常规治疗的基础上加服清下化瘀方.2组均治疗7d后,通过观察临床症状积分的缓解程度以及监测血淀粉酶、CRP、补体C3/C4,并给予APACHEⅡ积分评分评价其功能.[结果]治疗后2组患者的中医症状积分较治疗前均有明显下降,2组治疗前后胃肠道症状比较差异有统计学意义（P＜0.05或P＜0.01）.2组比较,血清CRP、血清补体C3、血淀粉酶差异均有统计学意义：治疗前2组血淀粉酶（AMY）明显高于正常值,治疗后2组AMY明显下降,治疗组恢复至正常值.2组治疗后血淀粉酶差值比较有统计学意义;治疗后2组CRP比较差异有统计学意义（P＜0.01）;2组治疗前C3、C4均有所上升,且2组比较差异无统计学意义;治疗后C3、C4恢复至正常水平,其中2组C3比较差异有统计学意义（P＜0.05）.2组治疗前评分值均接近重症急性胰腺炎的评分标准（APACHEⅡ评分≥8分）,经治疗后2组均有明显下降.[结论]清下化瘀方结合西药常规治疗急性胰腺炎,对其胃肠道及免疫功能有良好的保护作用.     

Changes in immune cell frequencies after cyclophosphamide or mycophenolate mofetil treatments in patients with systemic lupus erythematosus

This study was designed to explore the profile of immune cell subsets, including T, B, natural killer (NK), and NKT cells, in systemic lupus erythematosus (SLE) patients, and to determine their relationships with the clinical index and the effects of cyclophosphamide (CYC) and mycophenolate mofetil (MMF) treatment. SLE patients (n?=?28) and age/sex-matched healthy controls (n?=?28) were evaluated. The patients were equally divided into two treatment groups: intravenous drip (IVD) with CYC and prednisolone, and oral MMF and IVD with prednisolone. SLE peripheral blood samples were taken immediately prior to treatment and after 4?weeks of drug treatment. T, B, NK, and NKT cell subsets were measured by flow cytometry. Double-stranded DNA antibody and Sm antibody were detected by indirect immunofluorescence. Serum C3, C4, and C-reactive protein were determined by scatter turbidimetry. The percentages of CD3+CD4+ T, CD3-CD16CD56+ NK, and CD3+CD16CD56+ NKT cells and the CD4+/CD8+ ratio were significantly lower in SLE patients, while CD3+CD8+ T and CD3-CD19+ B cells were higher than the controls. The lymphocyte subsets were significantly correlated with the SLE disease activity index (SLEDAI) and complement factors (C3, C4). Four weeks of CYC or MMF treatment led to a significant increase in CD3+CD4+ T cells (P?相似文献   

Alterations of intestinal immune function and regulatory effects of L-arginine in experimental severe acute pancreatitis rats

ABM: To discuss the changes of intestinal mucosal immune function in rats with experimental severe acute pancreatitis (SAP) and the regulatory effect of L-arginine. METHODS: Male adult Wistar rats were randomly divided into pancreatitis group, sham-operation group, and L-arginine treatment group. Animals were killed at 24, 48, and 72 h after SAP models were developed and specimens were harvested. Endotoxin concentration in portal vein was determined by limulus endotoxin analysis kit. CD3+, CD4+, CD8+ T lymphocytes in intestinal mucosal lamina propria were examined by immunohistochemistry. Secretory immunoglobulin A (SIgA) in cecum feces was examined by radioimmunoassay. RESULTS: Compared to the control group, plasma endotoxin concentration in the portal vein increased, percentage of CD3+ and CD4+ T lymphocyte subsets in the end of intestinal mucosal lamina propria reduced significantly, CD4+/CD8+ ratio decreased, and SIgA concentrations in cecum feces reduced at 24, 48, and 72 h after SAP developed. Compared to SAP group, the L-arginine treatment group had a lower level of plasma endotoxin concentration in the portal vein, a higher CD3+ and CD4+ T lymphocyte percentage in the end of intestinal mucosal lamina propria, an increased ratio of CD4+/CD8+ and a higher SIgA concentration in cecum feces. CONCLUSION: Intestinal immune suppression occurs in the early stage of SAP rats, which may be the main reason for bacterial and endotoxin translocation. L-arginine can improve the intestinal immunity and reduce bacterial and endotoxin translocation in SAP rats.