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目的 研究西咪替丁对围手术期胃肠癌患者外周血T细胞亚群免疫功能的影响。 方法 胃肠癌患者49例,以围手术期是否应用Gim(400mg,3次/d,po,术前7d～10d;600mg,2次/d,至术后10d)随机分成治疗组和对照组。于入院时,手术前、手术后2,10d各抽取外周血1次,用免疫细胞化学方法检测T细胞亚群(鼠抗人CD3,CD4,CD8单抗)的变化。 结果 与正常人相比,治疗组与对照组中的胃肠癌患者外周血CD3~+,CD4~+细胞数明显减少(P<0.01),CD8~+细胞数明显增多(P<0.05),CD4~+/CD8~+比值明显降低(P<0.01)。治疗组与对照组相比,入院时两者间各指标无显著性差别(P>0.05),术前1d,术后2,10d的CD3~+,CD4~+,CD4~+/CD8~+高于对照组(P<0.01)。术后与术前相比,治疗组和对照组细胞免疫功能均下降,表现为CD3~+,CD4~+,CD4~+/CD8~+降低,CD8~+升高(P<0.05),但治疗组免疫功能下降的幅度低于对照组。 结论 胃肠癌患者细胞免疫功能下降,手术使其细胞免疫功能进一步下调;Cim能增强患者细胞免疫功能,降低手术对机体免疫损害的程度。
Objective To study the effect of cimetidine on the immune function of peripheral T lymphocyte subsets in patients with perioperative gastrointestinal cancer. Methods Forty-nine patients with gastrointestinal cancer were enrolled in this study. Patients were randomly divided into treatment group and control group with Gim (400mg, 3 times / d, po, preoperative 7d ~ 10d; 600mg, 2 times / . Peripheral blood samples were taken at admission, before surgery and 2 and 10 days after surgery. The changes of T cell subsets (mouse anti-human CD3, CD4 and CD8 monoclonal antibodies) were detected by immunocytochemistry. Results Compared with normal controls, the number of CD3 ~ + and CD4 ~ + cells in peripheral blood of patients with gastrointestinal cancer in the treatment group and the control group was significantly decreased (P <0.01) and the number of CD8 + cells was significantly increased (P <0.05) CD4 ~ + / CD8 ~ + ratio decreased significantly (P <0.01). Compared with the control group, there was no significant difference between the two groups (P> 0.05) on the 1st, the 1st, the 10th and the 10th postoperative day. The levels of CD3 +, CD4 +, CD4 + / CD8 + Higher than the control group (P <0.01). Compared with the preoperative, the immune function of the treated group and the control group decreased, the expression of CD3 +, CD4 +, CD4 + / CD8 + and CD8 + increased (P <0.05) The immune function of the treatment group decreased less than the control group. Conclusion The cellular immune function of patients with gastrointestinal cancer is decreased, and the cellular immune function is further decreased by surgery. Cim can enhance cellular immune function and reduce the degree of immune damage to the body.