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评估恶性梗阻性黄疸患者在胆道支架治疗前后免疫系统功能变化的相关性。

To evaluate the correlation between the change of immune system function before and after the treatment of malignant obstructive type jaundice treated with biliary stent.

机构信息

Department of Interventional Therapy, Xinxiang Central Hospital, Xinxiang, Henan, P.R. China.

出版信息

Eur Rev Med Pharmacol Sci. 2018 Mar;22(6):1638-1644. doi: 10.26355/eurrev_201803_14570.

Abstract

OBJECTIVE

To evaluate the correlation between the change of immune system function before and after the treatment of malignant obstructive type jaundice (MOJ) treated with a biliary stent.

PATIENTS AND METHODS

148 patients who were admitted to the Department of Digestive System for malignant obstructive jaundice were selected according to the standardized criterion. Amongst the total sample size, 78 were male patients and 70 were female patients, with an average age of (43.6 ± 5.5) years. After admission, the patients completed the blood routine examination and received biliary stent treatment to relieve the sign and symptoms of jaundice. Follow-up observation included total white blood cells, CD4+T cell count, CD8+T cell count, the ratio of CD4+/CD8, neutrophil counts neutrophils percentage, total bilirubin, free bilirubin, alanine aminotransferase (ALT), and inflammatory factors.

RESULTS

After three weeks of follow-up visit, CD4+T lymphocyte absolute value of patients markedly increased compared with that of pre-operation, and the difference had statistical significance (p < 0.05). The total bilirubin, free bilirubin, ALT, and inflammatory factors, such as hs-CRP, TNF-α in plasma of patients was significantly lower than that before the operation and the difference was statistically significant (p < 0.05). After six weeks of follow-up visit, the ratio of CD4+/CD8+ increased and the difference had statistical significance (p < 0.05) compared with that before biliary stent implantation. However, the white blood cell and neutrophil granulocyte did not improve significantly. It was found that CD4+/CD8+T lymphocyte had relation with the level of hs-CRP.

CONCLUSIONS

The patients with the (MOJ) treated with implanted biliary stent revealed relive in the obstruction of the biliary tract, which will further significantly improve the cholestasis. The ratio of CD4+/CD8+T lymphocyte increased, which will improve the immune system function of the patients, decreases the possibility of infection, and improves the overall survival quality.

摘要

目的

评估恶性梗阻型黄疸(MOJ)患者在接受胆道支架治疗前后免疫系统功能变化的相关性。

方法

根据标准化标准,选择 148 名因恶性梗阻性黄疸就诊于消化系统科的患者。在总样本量中,男性 78 例,女性 70 例,平均年龄(43.6±5.5)岁。入院后,患者完成血常规检查,并接受胆道支架治疗以缓解黄疸的症状和体征。随访观察包括总白细胞计数、CD4+T 细胞计数、CD8+T 细胞计数、CD4+/CD8+比值、中性粒细胞计数、中性粒细胞百分比、总胆红素、游离胆红素、丙氨酸氨基转移酶(ALT)和炎症因子。

结果

随访 3 周后,患者 CD4+T 淋巴细胞绝对值明显高于术前,差异有统计学意义(p<0.05)。患者血浆总胆红素、游离胆红素、ALT 和炎症因子如 hs-CRP、TNF-α明显低于术前,差异有统计学意义(p<0.05)。随访 6 周后,CD4+/CD8+比值升高,与胆道支架植入前相比差异有统计学意义(p<0.05)。然而,白细胞和中性粒细胞计数没有明显改善。研究发现 CD4+/CD8+T 淋巴细胞与 hs-CRP 水平有关。

结论

接受胆道支架植入治疗的 MOJ 患者胆道梗阻缓解,进一步明显改善胆汁淤积。CD4+/CD8+T 淋巴细胞比值升高,改善患者免疫系统功能,降低感染可能性,提高整体生存质量。

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