胸腔镜肺叶切除术对非小细胞肺癌患者炎性因子及免疫功能的影响

目的 分析胸腔镜肺叶切除术对非小细胞肺癌患者炎性因子及免疫功能的影响.方法 选取105例早期非小细胞肺癌患者作为研究对象,根据患者的病情及选择治疗方式的意愿,将其分为实验组(59例)和对照组(46例),实验组患者接受胸腔镜肺叶切除术,对照组患者接受常规开胸手术,记录两组患者切口长度、术中淋巴结清扫数目、术中出血量、术后引流量及手术时间等临床指标,分别于手术前后测定两组患者血清中白介素-6(IL-6)、白介素-8(IL-8)、C-反应蛋白(CRP)、肿瘤坏死因子-ɑ(TNF-ɑ)与降钙素原(PCT)等炎症因子水平及免疫球蛋白G(IgG)、免疫球蛋白A(IgA)与免疫球蛋白M(IgM)的水平,并于手术前后检测两组外周血T淋巴细胞亚群cd3+、cd4+、cd8+、cd4+/cd8+的水平,分析比较两组患者手术前后炎性因子水平变化及免疫功能状态.结果 与对照组比较,实验组患者的手术切口长度及手术时间明显缩短,患者术中出血量及术后引流量明显减少(P<0.05);术后两组IL-6、IL-8、CRP、TNF-ɑ与PCT等炎性因子水平较术前明显升高,且实验组患者术后炎性因子水平明显低于对照组(P<0.05);与术前水平比较,术后两组免疫球蛋白IgG、IgA与IgM水平有所下降,以IgG下降较为明显,且实验组术后IgG水平明显高于对照组(P<0.05);术后两组外周血T淋巴细胞亚群cd3+、cd4+、cd8+、cd4+/cd8+的水平明显低于术前水平,且实验组水平高于对照组(P<0.05).结论 胸腔镜肺叶切除术治疗非小细胞肺癌可明显减轻患者机体炎症反应,同时对患者机体免疫功能影响较小,且具有手术切口小、手术时间短,术中出血量少等特点,值得临床推广应用.

Effect of Thoracoscopic Lobectomy on Inflammatory Factors and Immune Function in the Patients with Non-small Cell Lung Cancer

Objective To study the effect of thoracoscopic lobectomy on inflammatory factors and immune function in the patients with non-small cell lung cancer .Methods 105 cases of early non-small cell lung cancer patients were divided into the experimental group (59 cases) and the control group (46 cases),the experimental group underwent thoracoscopic lobectomy ,the control group received routine thoracotomy , incision length , the number of lymph node , the quantity of bleeding , postoperative drainage volume and operation time and other clinical indicators of the 2 groups were measured before and after surgery ,interleu-kin-6 (IL-6),interleukin-8 (IL-8),C-reactive protein (CRP),tumor necrosis factor-ɑ (TNF-ɑ) and procalcitonin (PCT) and the level of inflammatory factors and immunoglobulin G ( IgG) ,immunoglobulin A ( IgA) and immunoglobulin M ( IgM) level of the 2 groups were detected ,and T lymphocyte subsets of peripheral blood cd 3 +、cd4 +、cd8 +、cd4 +/cd8 +levels before and after the operation were detected , The level of inflammatory factors and immune function of the 2 groups before and after surgery were com-pared.Results Compared with the control group ,incision length and operation time of the experimental group were significantly shorter, intraoperative bleeding and postoperative drainage volume was significantly reduced (P<0.05);The levels of IL-6,IL-8,CRP,TNF-and PCT inflammatory factors after surgery were significantly higher than those before surgery ,the levels of inflam-matory factors in the experimental group were significantly lower than those of the control group (P<0.05);and postoperative im-munoglobulin IgG ,IgA and IgM levels of the 2 groups decreased ,and IgG decreased obviously ,and IgG level after surgery in the experimental group was significantly higher than the control group (P<0.05);sub group cd3 +、cd4 +、cd8 +、cd4 +/cd8 +levels of T lymphocytes in peripheral blood of the 2 groups were significantly lower than the preoperative level after surgery ,and the experi-mental group was higher than the control group (P<0.05).Conclusion Thoracoscopic lobectomy for non-small cell lung cancer can significantly reduce the inflammatory reaction of patients ,at the same time has little effect on the immune function of patients with the body ,and has a small surgical incision ,shorter operation time ,less bleeding ,it is worthy of clinical application .