腹腔镜可调节捆扎带胃减容术对病态肥胖患者免疫功能的影响

目的比较病态肥胖症(MO)患者行腹腔镜可调节捆扎带胃减容术(LAGB)手术前后的免疫功能。方法MO组15例,平均体重指数(BMI)358kg/m2,于2003年6月2003年10月行LAGB,监测手术后体重变化。并于术前、术后1、3、6个月测定外周血T淋巴细胞总数(TLC)、T细胞亚群(CD+3、CD+4、CD+8、CD+4/CD+8)、自然杀伤细胞(NKC)百分比、血浆白细胞介素2(IL2)、白细胞介素6(IL6)浓度等免疫指标。对照组15例,平均BMI236kg/m2,入院时检测上述指标。应用SPSS110统计分析软件对各组数据进行统计学分析。结果MO组与对照组相比,术前CD+4、CD+4/CD+8显著降低(P<001),血浆IL2、IL6浓度显著升高(P<001)。LAGB术后6月体重、BMI、腰围及臀围均明显下降(P<001)。与术前相比,MO组术后6个月CD+4、CD+4/CD+8明显升高(P<005),但仍低于对照组(P<001);IL2、IL6浓度明显降低(P<001,P<005)。结论MO患者合并免疫功能异常,LAGB术后体重减轻后,免疫功能可部分改善。

Effect of weight loss induced by laparoscopic adjustable gastric banding on immunity of morbid obesity

OBJECTIVE: To compare the immunity of morbid obesity (MO) before and after laparoscopic adjustable gastric banding (LAGB). METHODS: 15 cases, with a mean body mass index (BMI) of 35.8 kg/m(2), were treated by LAGB from Jun. 2003 to Oct. 2003 in our department. Patients' immune parameters were determined preoperatively and 1, 3 and 6 months postoperatively. 15 cases with a normal BMI (23.6 kg/m(2)) were set as controls. RESULTS: Before surgery, the MO had a significant lower level of CD(4)(+), CD(4)(+)/CD(8)(+) and a higher level of serum interleukin-2 (IL-2), Interleukin-6 (IL-6) than the controls (P < 0.01). There was a significant reduction of weight and BMI 6 months postoperatively (P < 0.01). At the same time, CD(4)(+) increased and serum IL-2 decreased significantly. But CD(4)(+)/CD(8)(+)and serum IL-2, IL-6 were still abnormal compare to the controls. CONCLUSIONS: MO may combined with an abnormal immunity. But after enough weight loss induced by LAGB, it can be partly reversed.