CAJ | 학술논문

目的：探讨管状胃重建对食管癌患者免疫功能的影响。方法将92例食管癌患者随机分为两组，观察组46例，采用管状胃重建，对照组46例，采用全胃代食管行重建。分别于术前1 d，手术后第3、7天测定两组患者的 CD3+、CD4+、CD8+、CD4+/ CD8+、IgA、IgG 和 IgM 水平。结果两组患者的 CD3+、CD4+、CD4+/ CD8+水平在术后3 d 均明显减少（P ﹤0.05），CD8+水平均有所增加（P ﹤0.05）。对照组术后7 d CD3+、CD4+、CD8+、CD4+/ CD8+水平与术前1 d 比较差异无统计学意义（P ﹥0.05）。观察组术后7 d CD3+、CD4+、CD4+/ CD8+水平均比术前1 d 比较明显增高（P ﹤0.05）。并且两组术后7 d 比较，观察组 CD3+、CD4+、CD4+/ CD8+水平比对照组明显升高（P ﹤0.05），观察组 CD8+水平比对照组明显降低（P ﹤0.05）。两组患者血清 IgA、IgG、IgM 水平在术后3 d均有明显降低（P ﹤0.05）。术后7 d 血清 IgA、IgG、IgM 水平均有恢复，并且观察组血清 IgA、IgG、IgM 水平比对照组明显升高（P ﹤0.05）。结论管状胃重建有利于食管癌患者的免疫功能恢复。
목적：탐토관상위중건대식관암환자면역공능적영향。방법장92례식관암환자수궤분위량조，관찰조46례，채용관상위중건，대조조46례，채용전위대식관행중건。분별우술전1 d，수술후제3、7천측정량조환자적 CD3+、CD4+、CD8+、CD4+/ CD8+、IgA、IgG 화 IgM 수평。결과량조환자적 CD3+、CD4+、CD4+/ CD8+수평재술후3 d 균명현감소（P ﹤0.05），CD8+수평균유소증가（P ﹤0.05）。대조조술후7 d CD3+、CD4+、CD8+、CD4+/ CD8+수평여술전1 d 비교차이무통계학의의（P ﹥0.05）。관찰조술후7 d CD3+、CD4+、CD4+/ CD8+수평균비술전1 d 비교명현증고（P ﹤0.05）。병차량조술후7 d 비교，관찰조 CD3+、CD4+、CD4+/ CD8+수평비대조조명현승고（P ﹤0.05），관찰조 CD8+수평비대조조명현강저（P ﹤0.05）。량조환자혈청 IgA、IgG、IgM 수평재술후3 d균유명현강저（P ﹤0.05）。술후7 d 혈청 IgA、IgG、IgM 수평균유회복，병차관찰조혈청 IgA、IgG、IgM 수평비대조조명현승고（P ﹤0.05）。결론관상위중건유리우식관암환자적면역공능회복。
Objective To study the effect of tubular stomach reconstruction on immune function of patients with esophageal cancer. Methods Ninety-two patients with esophageal cancer were randomly divided into two groups,the 46 cases in observation group were operated through tubular stomach recon-struction,and the 46 cases in control group were operated through the replacement of esophagus by stom-ach reconstruction. The levels of CD3 + ,CD4 + ,CD8 + ,CD4 + / CD8 + ,IgA,IgG and IgM of the two groups were measured on 1 d before surgery,and the 3 th d,7 th d after surgery. Results The levels of CD3 + ,CD4 + ,CD4 + / CD8 + on 3 d after surgery significantly reduced in both groups(P ﹤ 0. 05),and the levels of CD8 + all increased(P ﹤ 0. 05). There were no significant differences in the levels of CD3 + , CD4 + ,CD8 + ,CD4 + / CD8 + in the control group between 7 d after operation and 1 d before operation (P ﹥ 0. 05). In the observation group,the levels of CD3 + ,CD4 + ,CD4 + / CD8 + were significantly higher on 7 d after operation than those on 1 d before surgery(P ﹤ 0. 05). The levels of CD3 + ,CD4 + , CD4 + / CD8 + in the observation group were significantly higher than those in the control group on 7 d af-ter operation(P ﹤ 0. 05). The levels of CD8 + in the observation group were significantly lower than those in the control group(P ﹤ 0. 05). The serum levels of IgA,IgG,IgM significantly reduced on the 3 d af-ter operation(P ﹤ 0. 05). The serum levels of IgA,IgG,IgM recovered on 7 d after operation,and the serum levels of IgA,IgG,IgM in the observation group were significantly higher than those in the control group(P ﹤ 0. 05). Conclusions Tubular stomach reconstruction is beneficial for immune function re-covery in patients with esophageal cancer.