rhGH对梗阻性黄疸患者术后免疫功能的影响

目的: 探讨重组人生长激素(rhGH)对梗阻性黄疸患者术后免疫功能的影响及临床意义.方法: 采用前瞻、随机、对照方法,对入选36例患者分为对照组(A组,n = 18)、rhGH组(B组,n = 18),B组加用rhGH,检测2组治疗前和治疗后1、8 d细胞免疫指标(CD3+、CD4+、CD4+/CD8+)、体液免疫指标(IgM、IgA、IgG)和免疫调节因子(IL-2、IL-6、TNF-α)的动态水平,并观察2组患者并发症和病死率的变化.结果: B组治疗后8 d与A组比较,CD3+、CD4+、CD4+/CD8+指标升高水平明显(42.32%±4.19% vs 31.51%±4.42%;26.36%±4.25%vs 19.29%±4.27%;1.22±0.20 vs 0.95±0.12,均P<0.05);IgA、IgG和IgM浓度明显升高(2.42±0.11 g/L vs 1.41±013 g/L;6.88±0.18g/L vs 4.89±0.15 g/L;1.84±0.18 g/L vs 1.28±0.24 g/L,均P<0.05);IL-6和TNF-α下降明显(0.42±0.11 mg/L vs 0.86±0.10 mg/L;11.04±1.52 pmol/L vs 18.24±1.22 pmol/L,均P<0.05),IL-2浓度显著升高(1.92±0.15 mg/L vs 1.14±0.12 mg/L,P<0.05);B组并发症发生率和病死率明显低于A组(22.22% vs 44.44%,0.00% vs5.56%,均P<0.05).结论: rhGH对梗阻性黄疸患者术后免疫功能具有直接的调理作用,能明显改善患者的免疫状态,有利于患者康复.

Influence of rhGH on postoperative immune function of patients with obstructive jaundice

AIM: To observe the clinical significance and changes of cytoimmunity,humoral immunity and immune regulatory factors after the administration of rhGH on patients with obstructive jaundice (OJ).METHODS: A prospective,randomized and controlled clinical study was performed,and 36 OJ cases were randomly divided into control group (A group,n = 18) and rhGH group (B group,n =18). rhGH were added in group B. A dynamic investigation of cytoimmunity indices (CD3+,CD4+and CD4+/CD8+),humoral immunity indices (IgA,IgG and IgM) and serum immune regulatory factors (IL-2,IL-6 and TNF-α) were conducted and mortality rate and complication rate of patients of two groups before therapy and at 1,8 d after operation were evaluated.RESULTS: Indexes of cytoimmunity indices (CD3+,CD4+ and CD4+/CD8+) in B group were obviously improved than A (42.32% ± 4.19%vs 31.51% ± 4.42%;26.36% ± 4.25% vs 19.29% ±4.27%;1.22 ± 0.20 vs 0.95 ± 0.12,all P < 0.05). Humoral immunity indices (IgA,IgG and IgM) in B group were obviously improved than group A 8 days after treatment (2.42 ± 0.11 g/L vs 1.41 ±013 g/L;6.88 ± 0.18 g/L vs 4.89 ± 0.15 g/L;1.84± 0.18 g/L vs 1.28 ± 0.24 g/L,all P < 0.05). Erum immune regulatory factors (IL-6 and TNF-α)were significantly decreased in B group (0.42± 0.11 mg/L vs 0.86 ± 0.10 mg/L;11.04 ± 1.52pmol/L vs 18.24 ± 1.22 pmol/L,both P < 0.05),IL-2 was obviously improved in group B (1.92± 0.15 mg/L vs 1.14 ± 0.12 mg/L,P < 0.05),and mortality rate and complication rate in group B were obviously lower than group A (22.22% vs 44.44%,0.00% vs 5.56%,both P < 0.05). CONCLUSION: RhGH has a direct immunoregulatory effect on patients with obstructive jaudice,which improves immunity of patients with obstructive jaundice and is good for their recovery.