Li H, Xiong S T, Zhang S X, Liu S B, Luo Y
Department of Surgery, Xiehe Hospital, Tongji Medical University, Wuhan.
J Tongji Med Univ. 1993;13(2):111-5. doi: 10.1007/BF02887926.
Sepsis is a major factor in the high mortality and morbidity following diagnostic and therapeutic procedures in patients with obstructive jaundice. The reasons for this increased susceptibility to infection are not fully understood. We therefore observed prospectively changes in immunological status of patients with obstructive jaundice in the perioperative period and studied immunological effects of perioperative arginine therapy. The results showed that there was a significant reduction in interleukin 2 (IL-2) production, interleukin 2 receptor (IL-2R) expression and lymphocyte response to phytohemagglutinin (PHA) mitogen in patients with obstructive jaundice compared with normal controls. After operation, the immune suppression in patients with obstructive jaundice was more significant. Arginine is a known T lymphocyte stimulator. Perioperative supplement with arginine significantly enhanced the immune function of patients with obstructive jaundice, the mechanism being related to increased IL-2 production and IL-2R expression.
脓毒症是梗阻性黄疸患者诊断和治疗后高死亡率及高发病率的主要因素。对感染易感性增加的原因尚未完全明确。因此，我们前瞻性观察了梗阻性黄疸患者围手术期免疫状态的变化，并研究了围手术期补充精氨酸的免疫效应。结果显示，与正常对照组相比，梗阻性黄疸患者白细胞介素2（IL-2）产生、白细胞介素2受体（IL-2R）表达及淋巴细胞对植物血凝素（PHA）丝裂原的反应显著降低。术后，梗阻性黄疸患者的免疫抑制更为明显。精氨酸是已知的T淋巴细胞刺激剂。围手术期补充精氨酸可显著增强梗阻性黄疸患者的免疫功能，其机制与IL-2产生增加及IL-2R表达增加有关。
