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目的:探讨胰腺癌患者围手术期机体免疫功能的变化。方法:动态观察40例胰腺癌患者围手术期外周血T淋巴细胞亚群、红细胞免疫功能指标RBC-C3bR和RBC-ICR、以及体液免疫指标IgG,IgA和IgM。结果:胰腺癌患者术前CD3,CD4,CD4/CD8比值及RBC-C3bR均明显降低,CD8 和RBC-ICR明显增高,血清免疫球蛋白IgG水平也呈升高趋势。其中T淋巴细胞亚群与红细胞免疫功能指标的变化具有一定的相关性。与胰腺癌未切除组相比,胰腺癌切除组手术后2 周T淋巴细胞亚群、红细胞免疫功能指标和血清免疫球蛋白IgG逐渐趋于恢复,术后30 d 基本恢复正常。结论:胰腺癌患者的免疫系统均有不同程度的损害,手术治疗有助于机体免疫功能的恢复。此外,对肿瘤患者免疫状态的观察不仅包括白细胞免疫系统,还应注重对红细胞免疫的监测。
Objective: To investigate the changes of perioperative immune function in patients with pancreatic cancer. Methods: Perioperative T lymphocyte subsets, red blood cell immune function indicators RBC-C3bR and RBC-ICR, and humoral immune markers IgG, IgA and IgM were dynamically observed in 40 patients with pancreatic cancer. RESULTS: Preoperative CD3, CD4, CD4/CD8 ratio and RBC-C3bR were significantly lower in patients with pancreatic cancer. CD8 and RBC-ICR were significantly higher, and serum immunoglobulin IgG levels were also increased. The T lymphocyte subsets have a certain correlation with the changes of red blood cell immune function indicators. Compared with the unresected pancreatic cancer group, T lymphocyte subsets, red blood cell immune function indicators and serum immunoglobulin IgG gradually recovered after 2 weeks of surgery in the pancreatic cancer resection group, and returned to normal after 30 days. Conclusion: The immune system of patients with pancreatic cancer has different degrees of damage. Surgical treatment is helpful for the recovery of immune function. In addition, the observation of immune status of cancer patients not only includes the white blood cell immune system, but also the monitoring of red blood cell immunity.