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目的 了解恶性梗黄疸患者细胞免疫功能被抑制状况及减黄术前后的变化。方法 应用单向免疫扩散法和酶联免疫吸附法动态监测 6 0例恶性梗黄疸患者围减黄手术期外周血免疫抑制酸性蛋白 (IAP)和可溶性白介素 受体 (SIL- 2 R)水平的变化并与同期 2 5例良性梗阻性黄疸患者及 40例正常人进行比较。结果 恶性梗黄疸患者血清 IAP和 SIL- 2 R水平术前 1天、术后 10天及 2 0天明显高于良性梗黄疸患者及正常人 (P<0 .0 1) ;良、恶性梗黄疸患者因手术创伤术后短期 IAP和 SIL- 2 R水平呈一过性增高 ,随病情的恢复和黄疸的减退 ,IAP和 SIL- 2 R水平逐渐下降 ,术后 2 0天良性梗阻性黄疸患者与正常人相比无显著性差异 (P>0 .0 5 ) ,恶性梗黄患者仍处于较高水平。结论 恶性梗黄患者外周血中免疫抑制物 IAP和 SIL- 2 R明显增高 ,患者的细胞免疫功能受到明显抑制而低下 ,减黄术可不同程度地改善患者的免疫功能。
Objective To investigate the suppression of cellular immune function in patients with malignant stem jaundice and the changes before and after the reduction of yellowing. Methods The levels of peripheral blood immunosuppressive acid protein (IAP) and soluble interleukin-2 receptor (SIL-2R) in 60 patients with malignant stem cell jaundice during perioperative period were measured by one-way immunodiffusion and enzyme-linked immunosorbent assay 25 patients with benign obstructive jaundice and 40 normal controls were compared. Results Serum levels of IAP and SIL-2 R in patients with malignant and severe cases of jaundice were significantly higher than those in patients with benign and malignant jaundice at 1 day, 10 days and 20 days after operation (P <0.01) Short-term IAP and SIL-2 R levels in patients with transient traumatic surgery showed a transient increase, with the recovery of the disease and the decline of jaundice, IAP and SIL-2 R levels decreased gradually, and postoperative patients with benign obstructive jaundice There was no significant difference between normal subjects (P> 0.05), patients with malignant lepromatosis were still at a high level. Conclusions The levels of immunosuppressive substances IAP and SIL-2R in peripheral blood of patients with malignant lepromatosis were significantly increased. The cellular immune function of patients with malignant lepromatosis was significantly inhibited and decreased. Radix diminished the immune function of patients with varying degrees of improvement.