| Objective:At present,surgical stress can interfere immune system function.in short,the postoperative immune function is suppressed which leads to immunodeficiency .The degree of immunodepression and the degree of surgical stress are closely related.The duration of the immunodepression's state is longer,the mortality which the infection or the pyotoxinemin of the postoperation gives rise to is higher.Along with the developing of laparoscopic operation,scholars of the internal and the external do a lot of zoopery and clinical research,they compare laparoscopic operation with conventional operation,demonstrate the former have lots of merits:Incision length,abdominal organs interference and patients distress of the former is less than the latter,recovery of the former is faster than the latter,but also the influence to stress,pulmonary function,gastrointestinal tract function,metabolism function,immune function of body is less.Recently,scholars of the internal and the external have many researchs about the influence of laparoscopic operation to body immune function,eg:T lymphocyte subgroups(including CD3,CD4 and CD8,et al),cytokines[including interleukin-1(IL-1),IL-2,IL-6,IL-8,IL-10 and tumor necrosis factorα(TNFα),et al] and immuoglobulins(including IgA,IgG and IgM,et al),however,about the influence to T-helper cell(TH1/TH2) subgroup balance and the secernent state of it controlling cytokines,it has less report.So,we research TH1/TH2 balance influence and TH1/TH2 cytokines secernent state between laparoscopic cholecystectomy operation (LC) and open cholecystectomy(OC).Methods:Immune function was examined in patients undergoing LC(n=30) and OC(n=30) for chronic cholecystitis and gallstones.Patients were matched for age,sex,incision length,operative time,anesthesia time,et al.T-helper cell content, TNFα and IL-10 levels were assessed preoperative hours 6,24,48.The balance of TH1 and TH2 cell detected by flow cytometery,following the old routine to isolate lympholeukocyte,add to stimlant PMA,Inomycin,Monensin,before it added to CD4+,IFNγ,IL-4 monoclonal antibody. TNFα and IL-10 levels were measured by enzyme-linked immunosorbent assay techniques.TH1 and TH2 cell content was indicated by accounting for CD4+ cell percentage.Data are expressed as (x ( s.All data were dealt with SPSS 10.0.Results were considered to be statistically significant at the 5% level.Results:1 The level of TH1 cell decreased significantly after the open surgery(P<0.05),and it was the lowest onpostoperative hours 6(accounting for 31.39% of preoperation),it accounted for 60.19% 0n postoperative hours 48;but the level of TH2 cell increased significantly after the open surgery (P<0.05),and it was the highest on postoperative hours 48.The level of TH1 and TH2 cell wasn't significantly in LC group(P>0.05),the difference of the data in two groups was all significantly(P<0.05).2 The level of TNFα decreased significantly after the open surgery(P<0.05),and it was the lowest on postoperative hours 6(accounting for 46.29% of preoperation) and it accounted for 58.88% 0n postoperative hours 48; but the level of IL-10 increased significantly after the open surgery (P<0.05),and it was the highest on postoperative hours 48.The level of TNFα and IL-10 wasn't significantly in LC group(P>0.05),the difference of the data in two groups was all significantly(P<0.05).3 The TH1/TH2 ratio and TNFα/IL-10 ratio decreased significantly after the open surgery(P<0.05),it wasn't significantly in LC group(P>0.05).Conclusions:1 The present study shows that OC,but not LC is associated with a marked shift in TH1/TH2 balance to TH2 anda deregulation of the pro-inflammatory and anti-inflammatory balance.2 LC has fewer influences on TH1/TH2 balance and immunologic suppression postoperatively.LC can preserve T cell function and cell-mediated immunity,the evaluation ofthis shift may be clinically meaningful and help quantify even less invasive surgical procedures.When comparing LC and OC in this not st... |
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