CAJ | 학술논문

目的探讨免疫调理对梗阻性黄疸患者术后感染并发症的防治作用及作用机理.方法采用前瞻、随机、单盲、对照临床研究分析40例结石性梗阻性黄疸患者.患者按随机原则分为对照组和治疗组各20例.对照组给予常规治疗.治疗组给予常规治疗联合使用蛋白酶抑制剂和胸腺肽α1(常规治疗+免疫调理),免疫调理疗程为7d.分别观察治疗前及治疗后1、3、5、7及14 d淋巴细胞计数和CD14+单核细胞人白细胞DR抗原(HLA-DR)水平等相关免疫学指标动态变化,同时收集临床术后感染资料.结果治疗组发生感染并发症2例,发生率10％.对照组发生感染并发症6例,发生率30％.两组感染并发症发生率差异有统计学意义(P＜0.01).治疗组淋巴细胞计数及CD14+单核细胞HLA DR水平在术后3d较对照组显著升高,并持续至治疗后14 d(P＜0.05).结论免疫调理可以升高淋巴细胞计数和CD14+单核细胞HLA-DR水平,从而改善免疫麻痹,临床上可有效降低梗阻性黄疸患者术后感染并发症发生率.
목적 탐토면역조리대경조성황달환자술후감염병발증적방치작용급작용궤리.방법 채용전첨、수궤、단맹、대조림상연구분석40례결석성경조성황달환자.환자안수궤원칙분위대조조화치료조각20례.대조조급여상규치료.치료조급여상규치료연합사용단백매억제제화흉선태α1(상규치료+면역조리),면역조리료정위7d.분별관찰치료전급치료후1、3、5、7급14 d림파세포계수화CD14+단핵세포인백세포DR항원(HLA-DR)수평등상관면역학지표동태변화,동시수집림상술후감염자료.결과 치료조발생감염병발증2례,발생솔10％.대조조발생감염병발증6례,발생솔30％.량조감염병발증발생솔차이유통계학의의(P＜0.01).치료조림파세포계수급CD14+단핵세포HLA DR수평재술후3d교대조조현저승고,병지속지치료후14 d(P＜0.05).결론 면역조리가이승고림파세포계수화CD14+단핵세포HLA-DR수평,종이개선면역마비,림상상가유효강저경조성황달환자술후감염병발증발생솔.
Objective To study the prevention and cure effect of immunoregulation therapy on postoperative infectious complications of calculous obstructive jaundice.Methods Prospective,randomized,blind and controlled clinical analysis of 40 patients conforming to the standard of calculous obstructive jaundice was carried out.The patients were divided into two groups at random.One was control group (n=20) with regular therapy,and the treatment group (n=20) with ulinastatin plus thymosin-α1 on the base of regular therapy for 1 week.The immunological indexes were determined before and after therapy on the 1st,3rd,5th、7th and 14th day,including the changes in lymphocyte count,CD14+ monocytes human leukocyte antigen (locus) DR (HLA-DR),and the incidence of postoperative infection were observed.Results The incidence of postoperative infectious complications in treatment group (10％) was remarkable lower than that in control group (30％,P＜0.01).There was significant difference between two groups (P＜0.05).After the 3rd,up to 14th day of therapy,the counts of lymphocyte and CD14+ monocytes HLA-DR were significantly higher than those in control group (all P＜0.05).Conclusions Immunoregulation therapy can improve the prognosis of obstructive jaundice patients in a period of 14 days of observation,and lymphocyte counts and CD14+monocytes HLA-DR were increased significantly,showing that immuno suppression can be ameliorated.Immunoregulation therapy could effectively prevent infectious complications of calculous obstructive jaundice.