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恶性阻塞性黄疸患者外周血淋巴细胞IL—2产生及IL—2R表达 总被引:1,自引:0,他引:1
恶性阻塞性黄疸患者术后极易发生感染,甚至脓毒血症,本文研究了恶性阻塞性黄疸患者外周血淋巴细胞IL-2产生及IL-2R表达能力的变化。结果显示,阻塞性黄疸患者外周血淋巴细胞IL-2产生能力明显下降,IL-2R表达也明显下降,恶性阻塞性黄疸患者外周血淋巴细胞IL-2生成能力及IL-2R表达受到明显抑制,与良性阻塞性黄疸组相比,差异具有显著性意义(P<0.05)。恶性阻塞性黄疸患者免疫功能明显受抑,可能 相似文献
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45例白血病患者,采用固相放射免疫分析法(RIA)测定其血清白细胞介素2(IL-2)的水平,以流式细胞仪(FCM)检测其外周血单个核细胞(PMNC)上膜白细胞介素2受体(mIL-2R)的表达,用双抗体夹心CELISA法测定其血清肿瘤坏死固子α(TNF-α)的含量。发现急性白血病(AL)及慢性位细胞白血病原始细胞危象(CML-BC)患者血清IL-2和TNF-α的水平明显高于正常,CML-BC尤其急淋变者的PMNC上mIL-2R阳性率较高,并与血清TNF-α有关,而与血清IL-2无关,mIL-2R阳性常提示白血病患者疗效差,预后不良。 相似文献
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肝癌患者外周血IL—2R检测及其意义 总被引:2,自引:0,他引:2
白细胞介素Ⅱ(IL—2)及白细胞介素Ⅱ受体(IL—2R)在人类免疫应答中起着重要作用。IL—2R包括膜表面受体(mIL—2R)及可落性受体(sIL—2R)二种类型。本文对肝癌患者外周血T细胞mIL—2R表达及血清sIL—2R含量进行研究,现将结果报道如下。 相似文献
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PTCD治疗恶性阻塞性黄疸临床研究 总被引:2,自引:0,他引:2
目的 探讨PTCD内、外引流对恶性阻塞性黄疸治疗的临床价值及术后对免疫功能、血浆内毒素的影响。方法在DSA引导下经皮肝穿刺肝内胆管留置引流管,检测治疗前后的血清总胆红素、直接胆红素、T细胞亚群及血浆内毒素水平。结果 治疗前CD3~+、CD4~+、CD4~+/CD8~+均明显低于正常,而血浆内毒素明显高于正常;治疗后CD3~+、CD4~+、CD4~+/CD8~+显著上升,而内毒素水平明显下降。内引流优于外引流,治疗2周后血清总胆红素下降216.5±36.4μmol/L,直接胆红素下降141±36.2μmol/L。结论 PTCD能有效地解除黄疸,提高机体免疫功能,改善症状,延长患者生存期。 相似文献
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肝癌特异性转移因子对IL—2活性及IL—2R表达的影响 总被引:2,自引:0,他引:2
用免疫山羊的淋巴组织经匀浆透析法制备抗肝癌特异性转移因子,并在体外观察其对IL-2活性及IL-24表达的影响。结果显示:肝癌特异性转移因子可明显地增加肝癌患者的IL-2活性及IL-2R表达,而对正常人的IL-2活性及IL-2R表达无影响,正常转移因子对正常人及肝癌患者的IL-2活性及I-2R表达均无影响;特异性转移因子可特异性地促进分泌IL-2和表达IL-2R异常的细胞恢复正常。提示这可能是特异性 相似文献
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恶性阻塞性黄疸患者减黄术前后免疫功能变化的研究 总被引:3,自引:0,他引:3
检测18例恶性阻塞性黄疸患者减黄术前1天,术后1、3、7、14和21天免疫功能变化另设20例良性阻塞黄疸患者为对照。结果显示:总补体、补体C3增高,sIL-2R术后先上升后下降,而后又再次上升,表明减黄术对改善恶性阻塞性黄疸患者免疫功能有效。 相似文献
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Internal-External Percutaneous Transhepatic Biliary Drainage for Patients with Malignant Obstructive Jaundice
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《Asian Pacific journal of cancer prevention》2014,15(21):9391-9394
Purpose: To evaluate the effect of internal-external percutaneous transhepatic biliary drainage (IEPTBD)for patients with malignant obstructive jaundice. Methods: During the period of January 2008 and July 2013,internal-external drainage was performed in 42 patients with malignant obstructive jaundice. During theprocedure, if the guide wire could pass through the occlusion and into the duodenum, IEPTBD was performed.External drainage biliary catheter was placed if the occlusion was not crossed. Newly onset of infection, degreeof bilirubin decrease and the survival time of patients were selected as parameters to evaluate the effect ofIEPTBD. Results: Twenty newly onset of infection were recorded after procedure and new infectious rate was47.6%. Sixteen patients with infection (3 before, 13 after drainage) were uncontrolled after procedure, 12 ofthem (3 before, 9 after drainage) died within 1 month. The mean TBIL levels declined from 299.53 umol/L beforedrainage to 257.62 umol/L after drainage, while uninfected group decline from 274.86 umol/L to 132.34 umol/Lp(P < 0.5). The median survival time for uninfected group was 107 days, and for infection group was 43 days (P< 0.05). Conclusions: The IEPTBD drainage may increase the chance of biliary infection, reduce bile drainageefficiency and decrease the long-term prognosis, and the external drainage is a better choice for patients withmalignant obstructive jaundice need to biliary drainage. 相似文献
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本文报告对肿瘤性黄疸病人行PTC86例,PTBD30例的临床体会。指出PTC方法简单、成功率高、合并症少。PTBD治疗梗阻黄疸作用分为术前减黄和姑息外引流两方面。尤其是不需X线设备,床旁体表定位下的PTBD17例,15例成功,更为简便、合并症少,对梗阻性黄疸有治疗价值。作者建议,对肿瘤性黄疸病人采用以下诊治步骤:B超→ERCP→床旁PTBD→经管造影,决定治疗方案为进一步手术治疗或永久带管外引流,提供有力依据。 相似文献
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Comparison of Infection between Internal-External and External Percutaneous Transhepatic Biliary Drainage in Treating Patients with Malignant Obstructive Jaundice
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《Asian Pacific journal of cancer prevention》2015,16(6):2543-2546
Purpose: Percutaneous transhepatic biliary drainage (PTBD) is a form of palliative care for patientswith malignant obstructive jaundice. We here compared the infection incidence between internal-externaland external drainage for patients with malignant obstructive jaundice. Methods: Patients with malignantobstructive jaundice without infection before surgery receiving internal-external or external drainage fromJanuary 2008 to July 2014 were recruited. According to percutaneous transhepatic cholangiography (PTC), ifthe guide wire could pass through the occlusion and enter the duodenum, we recommended internal-externaldrainage, and external drainage biliary drainage was set up if the occlusion was not crossed. All patients withinfection after procedure received a cultivation of blood and a bile bacteriological test. Results: Among 110patients with malignant obstructive jaundice, 22 (52.4%) were diagnosed with infection after the procedure inthe internal-external drainage group, whereas 19 (27.9%) patients were so affected in the external drainagegroup, the difference being significant (p<0.05). In 8 patients (36.3%) in the internal-external group infectionwas controlled, as compared to 12 (63.1%) in the external group (p< 0.05). The mortality rate for patients withinfection not controlled in internal-external group in one month was 42.8%, while this rate in external group was28.6% (p< 0.05). Conclusion: External drainage is a good choice, which could significantly reduce the chance ofbiliary infection caused by bacteria, and decrease the mortality rate at one month and improve the long-termprognosis. 相似文献
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目的探讨磁共振胰胆管成像(magnetic resonance cholangiopancreatography,MRCP)对恶性梗阻性黄疸的诊断价值,提高MRCP对恶性梗阻性黄疸的诊断准确性。方法总结80例恶性病变致梗阻性黄疸的MRCP及常规MRI(磁共振成像)的影像学特征,将MRCP诊断结果与手术病理检查结果进行对照,分析MRCP诊断的准确性及各种恶性梗阻性黄疸MRCP的特征性表现。结果 MRCP对恶性梗阻性黄疸的定位诊断及梗阻近端胆管显示率为100.0%;对恶性梗阻性黄疸的的诊断准确率为83.8%,定位、定性诊断特异性高。结论 MRCP对恶性梗阻性黄疸的定位诊断准确率达100.0%;在定性诊断中有重要地鉴别诊断价值;能明显提高对恶性梗阻性黄疸的诊断准确率。 相似文献
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[目的]探讨经内镜胆道支架置入内引流(ERBD)术治疗晚期恶性梗阻性黄疸的临床疗效及其对细胞免疫功能的影响。[方法]收集2009年1月至2012年12月间接受ERBD术的晚期恶性梗阻性黄疸患者的临床资料并随访。[结果]58例中51例成功置入支架,成功率为87.9%。支架置入组患者术后黄疸逐渐消退,皮肤瘙痒等症状明显缓解或消失,术后3d、1周血清TB、DB、AST、ALT、ALP、GGT各项指标与术前相比均明显下降(P均<0.05)。术后细胞免疫功能逐步改善,与术前比较术后2周的CD3+、CD4+、CD4+/CD8+水平明显升高(P均<0.05)。[结论]ERBD术治疗恶性胆道梗阻疗效确切,同时能一定程度地改善患者细胞免疫功能,对提高患者生存质量,延长生命具有较满意效果。 相似文献
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[目的]观察恶性梗阻性黄疸患者于经皮肝穿刺胆道造影及引流术(PTCD)术后血清总胆汁酸(TBA)、总胆红素(TBL)及直接胆红素(DBL)的变化。[方法]122例恶性梗阻性黄疸患者PTCD术前1d及术后第3d至4周内作TBA、TBL、DBL检测。[结果]PTCD术前TBA(131.8±76.6μmol/L)与TBL(416.0±127.5μLmol/L)、DBL(300.4±86.9μmol/L)有良好相关性(r值:0.358、0.379,P〈0.05);术后3dTBA下降明显(15.9±22.6μmol/L),与术前(131.8±76.6μmol/L)比较有显著性差异(P〈0.01)。[结论]血TBA可作为检验PTCD术后黄疸引流是否有效的可靠指标。 相似文献
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目的 探索PTC下胆道活检的可行性和敏感性 ,获取病变胆管的组织病理学 ,指导临床治疗。方法 19例恶性阻塞性黄疸 ,在行PTCD(经皮经肝穿刺胆道内外引流术 )减黄术中 ,PTC下胆道活检 ,进行组织病理学检查。结果 19例患者中有 18例获得组织病理学诊断 (敏感性 ,94 74% )。病理报告为胆管癌n =13 ,胰腺癌n =2 ,转移瘤n =2 ,肝细胞癌n =1,阴性结果n =1,阳性结果率为 94 74%。结论 PTC胆道活检是一种准确可靠的获取组织病理学检查途径 相似文献
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[目的]分析恶性梗阻性黄疸患者行PTCD前后应用药物进行预处理以减少术后急性胰腺炎的发生。[方法]对40例高龄、低位恶性肿瘤所致梗阻性黄疸患者,行DSA引导下VrCD胆道支架植入及肝外引流管植入治疗。分为对照组及药物预处理组,每组20例。对照组术前、术后不行预防性用药:药物预处理组患者术前1h预防性皮下注射醋酸奥曲肽0.1mg,术后继续皮下注射醋酸奥曲肽0.1mg,每8h1次,连续3d。分别于术前、术后24h、48h及72h观察两组患者症状体征,复查血、尿淀粉酶及胰腺CT情况。[结果]72h内药物预处理组与对照组恶心呕吐情况无差异(P〉0.05);腹痛及腹膜炎情况药物预处理组轻于对照组(P〈0.05);血淀粉酶升高例数药物预处理组明显多于对照组(P〈0.01);尿淀粉酶升高例数药物预处理组明显多于对照组(P〈0.05);术后72h内腹部CT阳性例数药物预处理组6例、对照组1例(P〈0.05);药物预处理组术后确诊胰腺炎1例,对照组7例(P〈0.05)。[结论]针对高龄、低位恶性梗阻性黄疸患者行PTCD治疗时,可于术前及术后预防性应用醋酸奥曲肽。以减少术后发生急性胰腺炎概率或减轻术后急性胰腺餐病情程摩有利干患者术后恢复. 相似文献