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。

Effect of High-dose Vitamin C on Cellular Immunity of Patients with Acute Pancreatitis

Background: Damage to cellular immune function and depletion of vitamin C (Vit C) occur in patients with acute pancreatitis (AP). Vit C can improve the oxidative scores and immune function in AP patients. Aims: To observe the effect of high-dose Vit C on cellular immunity of AP patients. Methods: 84 cases of AP patients were randomly divided into treated group and controlled group, and 40 healthy volunteers were served as normal group. In the treated group, Vit C 10 g/d was given intravenously for 5 days. In the controlled group, Vit C 1 g/d was given intravenously for 5 days. The concentration of plasma Vit C and T lymphocyte subsets were measured in normal group, treated group and controlled group before and after treatment with Vit C. Results: Compared with the normal group, the CD3 and CD4 cells of the AP patients decreased remarkably. The CD4 cells and the ratio of CD4/CD8 decreased, especially in patients with severe acute pancreatitis (SAP) (P<0.05). After treatment with high-dose Vit C, the CD4 cells and the ratio of CD4/CD8 in treated group of SAP patients were significantly higher than those in controlled group (P<0.05). Conclusions: Disturbance of cellular immune function occurs in patients with AP, in particular SAP. Intravenous infusion of high-dose Vit C can improve the immune function of patients with SAP.