阻塞性黄疸患者外周血内毒素和T淋巴细胞亚群变化的研究

对３２例阻塞性黄疸（下称阻黄）患者的外周血内毒素含量和Ｔ淋巴细胞亚群进行测定。结果发现阻黄患者内毒素阳性率为５９．３８％，平均０．０２８±０．０６ＥＵ／ｍｌ。中重度组的阳性率远高于轻度组（Ｐ＜０．０５）。术后一周９２．８６％患者转为阴性，术后二周全部阴性。胆道阻塞患者ＣＤ３降低（Ｐ＜０．０５），ＣＯ４在中重度组也明显降低（Ｐ＜０．０５），中重度组和恶性组的Ｃ０／ＣＤ８比值降低（Ｐ＜０．０５），术后二周患者的免疫功能尚未恢复正常。术后并发症发生率和手术死亡率以中重度组和恶性组为高。上述结果表明阻黄患者存在内毒素血症和细胞免疫功能降低，与阻黄患者术后并发症多和死亡率高有关。

A STUDY OF ENDOTOXIN AND ALTERED T LYMPHOCYTESUBSETS IN PATIENTS WITH OBSTRUCTIVE JAUNDICE

ndotoxin and T lymphocyte subsets were studied in the peripheral blood of 32 patientswith obstructive jaundice. The results showed that 59. 50% patients with OJ had eridotox-emia. The middle and severe groups had higher positive rate of endotoxemia than the mildgroup. After operation, all. patients were free of endoxemia within two weeks. When com-pared with normal controls , there were a significant reduction in the percentage of CD3 cellsof all OJ patients and a significant decrease in the ratio of CD4/CD8 cells in the middle and se-vere OJ group and malignant group patients (P<0. 05). The percentage of CD4 cells was alsosignificantly reduced in middle and severe group patients (P<0. 05). The immunity capacityin postoperative patients had not recovered to normal by two weeks. These findings showthat endotoxemia and the impairment of cell-mediated immunity significantly attnbated to thedevelopment of complication and death in obstructive jaundice.