【作者】 杨奎忠；

【导师】 徐瑞荣；

【作者基本信息】 山东中医药大学 ， 中西医结合临床， 2004， 硕士

【摘要】 目的：探讨非小细胞肺癌患者围术期免疫功能变化规律，观察当归补血汤Ⅰ号对肺癌患者围术期免疫功能的影响及疗效。方法：应用间接免疫荧光法检测T淋巴细胞亚群，放射性核素释放法测定NK细胞活性，应用单向免疫扩散法检测血清IgA、IgM、IgG；采用双抗体夹心酶联免疫吸附法(ELISA)检测血清白细胞介素-2(IL-2) 、肿瘤坏死因子-α(TNF-α)，放射免疫法检测细胞角蛋白19片段(CYFRA21-1) 、癌胚抗原(CEA)，并对一般情况进行评估，应用SAS6． 2统计软件包进行统计学分析。结果：非小细胞肺癌患者术前细胞及体液免疫功能较正常人明显减低(P<0． 05) ，血清IL-2水平明显降低，而TNF-α明显升高，CYFRA21-1及CEA水平明显升高，与正常健康者相比差别显著(P<0． 05) ，术后一周内免疫功能进一步受抑制，术后3～4周方能达正常水平，而试验组在围术期及术后应用当归补血汤Ⅰ号，则术后免疫抑制明显减轻，术后10～14天可达正常水平，并且可一直维持较好状态，与对照组相比差异显著(p<0． 05) 。肿瘤标记物与对照组相比，明显降低，维持正常。结论：1． 非小细胞肺癌患者存在免疫功能抑制，与病情进展情况相关。免疫抑制为肿瘤源性，而实性占位的存在是免疫抑制的病理基础。在切除肿瘤后免疫功能得以恢复。2． 非小细胞肺癌患者在术后早期免疫功能受损进一步加重，应辅助免疫治疗，应用当归补血汤Ⅰ号可减轻患者术后早期免疫功能受损程度，并提高患者免疫功能恢复的速度，增强免疫力，并有一定的抗肿瘤作用。利于术后恢复，提高生活质量，增强山东中医药大学2001届硕士学位论文患者信心。当归补血汤I号对人血常规指标、肝功能、肾功能无不良影响，试验过程中未见不良反应 3.动态监测非小细胜明市癌患者的免疫功能及肿瘤标志物状况，可作为判断非小细胞肺癌患者病情发展状况、治疗效果指标。更多还原

【Abstract】 Objective To study the variety regulation of immune function of non-small cell lung cancer patient during perioperative ,and observe influence to immune function of NSCLC patient during perioperative by the No.l Chinese Angelica Decoction for Replenishing Bolld.Method T-lymphocte subsetshe were measured by indirect immunity fluorescence. The active of Natural killer cell second were measured by radioactive nuclide release . The serum levels of IgA, IgM, IgG were measured by single direction immunity diffuse. The serum levels of IL-2 and TNF- α were measured by enzyme-linked immunosorbent assay(ELISA) . The serum levels of CYFRA21-1 and CEA were measured by radioimmunoassay(RIA). And the general condition were evaluated. The software package of statistics SAS6.2 were applicated to proceed the statistics analysis.Result Cell and body liquid immune function of NSCLC were obviously turn down compared to the healthy people (P<0.05). the serum levels of IL-2 were obviously lower. but the serum levels of TNF- a was very high . the serum levels of CYFRA21-1 and CEA were also obviously go up.the statistically significant difference was found compared to the healthypeople ( P<0.05).In one week postoperation , immune function were further restrained. After three or four weeks ,the immune function of NSCLC can reach normal level.but the restrained of immune function postoperation of the group which taking NO.l Chinese Angelica Decoction for Replenishing Bolld during perioperative were obvious alleviated; After two weeks ,the immune function can reach the normal level and always maintain the good condition, the statistically significant difference was found compared to matched control( P<0.05). Conclusion1. Immune function of NSCLC was restrained by tumour.The degree of restrain has correlate with the TNM stage.The pathologic basic is tumor lump. After the excision of tumor, the immune function of NSCLC that has been restrained can comeback gradually.2. In one week postoperation, immune function were further restrained. Taking NO.l Chinese Angelica Decoction for Replenishing Bolld during perioperative, can obviously alleviate the degree of immune function restrained postoperation; it can exaltation the speed of recovery of immune function .strengthen immunity function. Benefit postoperation recover, increasing the living quality; strengthen patient’s confidence.it has no effect to liver function and kidney function; during the process of experiment did not see the bad reaction.3. Dynamic monitor the immune function and tumor marking of NSCLC, can be used as the judgment index of NSCLC patient’s illness condition and treatment result.更多还原