Garcia-Valdecasas J C, Martinez A, Lopoez-Boado M A, de Lacy A M, Cugat E, Grande L, Fuster J, Visa J, Pera C
Department of Surgery, Hospital Clinico y Provincial, University of Barcelona, Spain.
Hepatogastroenterology. 1988 Oct;35(5):219-22.
A generalized state of immunosuppression during surgery has been implicated in the development of septic complications postoperatively. We studied 18 patients operated upon for benign diseases, to examine the influence of surgical trauma on circulating lymphocyte subpopulations in man. Additionally, we evaluated the effect of thymostimulin on these changes, in another group of 10 patients. Our results suggest that the total number of lymphocytes, as well as lymphocyte subpopulations CD3+ and CD4+, fell significantly following surgery. This reduction in cell number is more pronounced on the helper/inducer lymphocytes. The CD4+/CD8+ ratio decreases significantly after operation. For patients with no complications, the immunosuppression in terms of peripheral lymphocyte population, seen in the postoperative period is usually reversible around the seventh day. On the other hand, peripheral blood lymphocyte changes in the postoperative period were less pronounced in patients treated with thymostimulin. Thymostimulin's action is predominantly on T lymphocytes, and within these, on the T helper/-inducer subpopulation. And finally, thymostimulin is capable of maintaining a normal relationship between helper/inducer and suppressor/cytotoxic cells (CD4+/CD8+ ratio) during the postoperative period, suggesting a better immune state.
手术期间普遍存在的免疫抑制状态被认为与术后脓毒症并发症的发生有关。我们研究了18例因良性疾病接受手术的患者，以探讨手术创伤对人体循环淋巴细胞亚群的影响。此外，我们在另一组10例患者中评估了胸腺刺激素对这些变化的作用。我们的结果表明，手术后淋巴细胞总数以及淋巴细胞亚群CD3 +和CD4 +显著下降。这种细胞数量的减少在辅助/诱导淋巴细胞上更为明显。术后CD4 + / CD8 +比值显著降低。对于无并发症的患者，术后外周淋巴细胞群的免疫抑制通常在第七天左右可逆。另一方面，接受胸腺刺激素治疗的患者术后外周血淋巴细胞变化不那么明显。胸腺刺激素的作用主要在T淋巴细胞上，在这些细胞中，作用于T辅助/诱导亚群。最后，胸腺刺激素能够在术后维持辅助/诱导细胞与抑制/细胞毒性细胞之间的正常关系（CD4 + / CD8 +比值），表明免疫状态更好。
