西咪替丁对围手术期胃肠癌患者T细胞亚群的影响

目的研究西咪替丁对围手术期胃肠癌患者外周血T细胞亚群免疫功能的影响.方法胃肠癌患者49例,以围手术期是否应用Cim(400mg,3次/d,po,术前7 d～10 d;600mg,2次/d,至术后10 d)随机分成治疗组和对照组.于入院时,手术前、手术后2,10 d各抽取外周血1次,用免疫细胞化学方法检测T细胞亚群(鼠抗人CD3,CD4,CD8单抗)的变化.结果与正常人相比,治疗组与对照组中的胃肠癌患者外周血CD3+,CD4+细胞数明显减少(P＜0.01),CD8+细胞数明显增多(P＜0.05),CD4+/CD8+比值明显降低(P＜0.01).治疗组与对照组相比,入院时两者间各指标无显著性差别(P＞0.05),术前1 d,术后2,10 d的CD3+,CD4+,CD4+/CD8+高于对照组(P＜0.01).术后与术前相比,治疗组和对照组细胞免疫功能均下降,表现为CD3+,CD4+,CD4+/CD8+降低,CD8+升高(P＜0.05),但治疗组免疫功能下降的幅度低于对照组.结论胃肠癌患者细胞免疫功能下降,手术使其细胞免疫功能进一步下调;Cim能增强患者细胞免疫功能,降低手术对机体免疫损害的程度.

Effects of cimetidine on T lymphocyte subsets in perioperative gastrointestinal cancer patients

AIM To study the effects of cimetidine (Cim) on the immune function of peripheral blood lymphocyte subsets in patients with gastrointestinal cancer. METHODS Forty-nine patients were divided into treatment group ( n = 25 ) who took Cim during perioperative period, and control group (n = 24) who did not take any medicine. CD3 , CD4 and CD8 cells were measured by immunocytochemical stain method in the perioperative period.RESULTS Compared with normal control, the percentages of CD3 , CD4 cells and CD4 /CD8 ratio in patients with gastrointestinal cancer were significantly lower (P<0.01), and the percentage of CD8 cells was significantly higher (P<0.05). At admission, the parameters were not significantly different between treatment group and control group (P>0.05), while the percentages of CD3 , CD4 cells and CD4 / CD8 ratio before operation, on the 2nd and 10th postoperative days in the treatment group were significantly higher than those in the control group (P<0.01). The cellular immunity-positive cells in both groups were much lower after operation than before operation (P<0.05). However, the degree of decrease was much smaller in the treatment group than in the control group.CONCLUSION The cellular immunity-positive cells are lower in gastrointestinal cancer patients, and they are further down-regulated by operation. Cim can boost the patients' cellular immunity, and alleviate the damage to hosts' immunity due to operation.