微波固化保肢术对骨肉瘤患者Th1/Th2漂移的逆转

目的：研究微波组织固化保肢技术对患者免疫功能的影响。方法：应用放射免疫分析法以及酶联免疫分析法检测20例行微波组织固化保肢术组骨肉瘤患者及20例其它手术组患者手术前后血清IL－2,IL－4,IL－6,IL－10,IL－12的含量,应用流式细胞仪检测患者淋巴细胞亚群的变化。结果：与正常对照相比,骨肉瘤患者CD4^ T细胞,血清中IL－2,IL－12减少（P＜0．01）,CD8^ T细胞,IL－10,IL－4,IL－6含量升高（P＜0．01）,CD4／CD8比值降低（P＜0．01）,患者免疫功能受到抑制;术后30天截肢组及保肢组CD4^ T细胞,血清中IL－2,IL－12均升高,CD8^ T细胞,IL－10,IL－4,IL－6含量降低（P＜0．01）,CD4／CD8比值升高（P＜0．01）,患者免疫功能较术前改善;与截肢组比较,保肢组患者CD4^ T细胞、IL－2,及CD4／CD8比值30天上升幅度明显高于截肢组（P＜0．01）,CD8^ T细胞,IL－4,IL－6 30天降低幅度明显高于截肢组（P＜0．01）。IL－2,IL－12与CD4^ 细胞成正相关,IL－4,IL－6,IL－10与CD4^ T细胞成负相关。结论：微波固化保肢术可以加速逆转骨肉瘤患者Th1/Th2和Th2漂移,增强患者的免疫功能。

The Switching of Th2 to Thl in Osteosarcoma Patients Treated by Limb Salvage Conjunction with Microwave Tissue Coagulation (MTC)

Objective:To study the changes of immunological function before and after limb salvage by MTC in osteosarcoma patients.Methods:Using RIA and ELISA,serum levels of IL-2,IL-4,IL-6,IL-10,IL-12were examined in20MTC patients and20surgical patients before and after treatment.T lymphocyte subset of peripheral blood were investigated by an di -rect immunofluorescent staining method with flow cytometry.Results:The percentage of CD 4 T cell,IL-2,IL-12and CD 4 /CD 8 ratio declined obviously(P<0.01)before treatment,on contrast,IL-4,IL-6,IL-10increased obviously.The percentage of CD 4 T cells,IL-2,IL-12levels and CD 4 /CD 8 ratio increased(P<0.01),but a significant decrease of CD 8 T cells,IL-4,IL-6,IL-10(P<0.01)was observed in patients treated with surgery and MTC after30days.The most dra-matic changes in the MTC patients were not only CD 4 T cells,IL-2,and CD 4 /CD 8 ratio increased more quickly than those in the surgery group,but IL-4,IL-6and CD 8 T cell also declined quickly(P<0.01).The correlation coefficient of cytokines and CD 4 T cell in the same group was more than0.41(P<0.05).Conclusion:The results suggest that MTC can improve the change of cytokine pattern from Th2to Th1.