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回顾性分析恶性梗阻性黄疸内外引流前后 T 淋巴细胞亚群及细胞因子变化

Retrospective analysis of T-lymphocyte subsets and cytokines in malignant obstructive jaundice before and after external and internal biliary drainage.

机构信息

Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China.

Department of Radiology, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, Hebei Province, PR China.

出版信息

J Int Med Res. 2021 Feb;49(2):300060520970741. doi: 10.1177/0300060520970741.

Abstract

OBJECTIVE

To study changes in T lymphocyte subsets, cytokines, and liver enzymes in patients with malignant obstructive jaundice (MOJ) before and after external biliary drainage (percutaneous transhepatic cholangiography drainage, PTCD) and internal biliary drainage (percutaneous transhepatic insertion of biliary stents, PTIBS).

METHODS

MOJ patients undergoing PTCD (n = 44) and PTIBS (n = 38) at our hospital were enrolled in the study from January 2017 until December 2019. Peripheral blood total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), CD3%, CD4%, CD4/CD8 ratio, interleukin (IL)-2, IL-6, and tumor necrosis factor (TNF)-α were measured before and 1 week after biliary drainage.

RESULTS

There was no significant difference in any parameter between the two groups before biliary drainage. TBIL, DBIL, AST and ALT following PTCD were significantly lower than before PTCD. By contrast, CD3%, CD4%, CD4/CD8 ratio, IL-2, IL-6 and TNF-α showed no significant difference before and 1 week after PTCD. TBIL, DBIL, AST, ALT, IL-6 and TNF-α were significantly lower following PTIBS than before PTIBS. CD3%, CD4%, CD4/CD8 ratio and IL-2 were significantly higher following PTIBS than before PTIBS.

CONCLUSION

Both PTCD and PTIBS were effective for treatment of MOJ, but PTIBS was more beneficial for recovery of immune function.

摘要

目的

研究恶性梗阻性黄疸(MOJ)患者在外引流(经皮经肝胆管引流术,PTCD)和内引流(经皮经肝胆管支架置入术,PTIBS)前后 T 淋巴细胞亚群、细胞因子和肝酶的变化。

方法

本研究纳入了 2017 年 1 月至 2019 年 12 月期间在我院接受 PTCD(n=44)和 PTIBS(n=38)的 MOJ 患者。分别在胆道引流前和引流后 1 周测量外周血总胆红素(TBIL)、直接胆红素(DBIL)、天门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、CD3%、CD4%、CD4/CD8 比值、白细胞介素(IL)-2、IL-6 和肿瘤坏死因子(TNF)-α。

结果

胆道引流前两组各参数均无显著差异。PTCD 后 TBIL、DBIL、AST 和 ALT 明显低于 PTCD 前。相比之下,PTCD 前后 CD3%、CD4%、CD4/CD8 比值、IL-2、IL-6 和 TNF-α无显著差异。PTIBS 后 TBIL、DBIL、AST、ALT、IL-6 和 TNF-α明显低于 PTIBS 前。PTIBS 后 CD3%、CD4%、CD4/CD8 比值和 IL-2明显高于 PTIBS 前。

结论

PTCD 和 PTIBS 治疗 MOJ 均有效,但 PTIBS 更有利于免疫功能的恢复。

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