Holch M, Grob P J, Fierz W, Glinz W, Geroulanos S
Helv Chir Acta. 1989 Jun;56(1-2):121-4.
The present prospective study was performed to describe physiological immunosuppressive effects dependent on minor surgical interventions and an immunodeficiency syndrome after major surgery and severe trauma. Parameters of cellular and humoral immunity were monitored in 64 patients of the Department of Surgery of the University Hospital Zurich preoperatively and on days 1, 2, 3 and 4 after selective surgery or polytrauma. 22 patients were multiply traumatized (mean ISS 34.7 +/- 13), 14 patients underwent Y-grafting of the abdominal aorta, 11 resection of colorectal carcinoma, 8 cholecystectomy and 9 inguinal herniotomy. There could be seen a decrease of parameters of cellular immunity (absolute lymphocyte count, CD-4-/CD-8-cell-ratio and release of IL2-receptors), a decrease of humoral defense (immunoglobulins and complement factors) and an increase of macrophage activation (serum levels of neopterin).
本前瞻性研究旨在描述依赖于小手术干预的生理免疫抑制作用以及大手术和严重创伤后的免疫缺陷综合征。对苏黎世大学医院外科的64例患者术前以及选择性手术或多发伤后第1、2、3和4天的细胞免疫和体液免疫参数进行了监测。22例患者为多发伤（平均损伤严重度评分34.7±13），14例患者接受了腹主动脉Y形移植术，11例患者接受了结肠直肠癌切除术，8例患者接受了胆囊切除术，9例患者接受了腹股沟疝修补术。可见细胞免疫参数（绝对淋巴细胞计数、CD4⁻/CD8⁺细胞比值和IL-2受体释放）降低，体液防御（免疫球蛋白和补体因子）降低，巨噬细胞活化增加（新蝶呤血清水平）。
