消炎痛对阻塞性黄疸患者外周血淋巴细胞白细胞介素-10、白细胞介素-2水平的影响

目的研究阻塞性黄疸患者外周血淋巴细胞白细胞介素-10(IL-10)、白细胞介素-2(IL-2)水平和血浆中前列腺素E2(PGE2)水平的变化,同时观察消炎痛对上述指标的影响。方法给阻塞性黄疸患者口服消炎痛(25mg,1次/8小时),用药前和用药后7d取外周血,分别用放射免疫和ELISA法测血浆中PGE2水平及外周血淋巴细胞IL-10、IL-2水平。结果用药前阻塞性黄疸患者血浆中PGE2水平及外周血淋巴细胞IL-10水平较正常人明显升高,而IL-2水平明显下降,且IL-10、IL-2的水平与PGE2水平显著相关;用药后,患者血淋巴细胞IL-2水平明显升高,而IL-10水平及血浆中PGE2水平明显下降,与用药前相比差异有统计学意义。结论阻塞性黄疸患者淋巴细胞IL-10、IL-2水平的变化与其血浆中PGE2水平升高有关,消炎痛能够明显缓解这种作用。     

阻塞性黄疸血浆PGE2与淋巴细胞IL-10和IL-2活性的相关性分析

为探讨阻塞性黄疸大鼠血浆PGE2与血淋巴细胞IL-10,IL-2水平的动态变化及它们的相关性，笔者将70只SD大鼠随机分为对照（10只），胆总管结扎（BDL）1,2,3周等4组（各20只）。分别测定各组大鼠血浆PGE2和血淋巴细胞IL-10和IL-2水平的动态变化，并进行相关分析。结果示大鼠血浆PGE2 和血淋巴细胞IL-10水平在BDL后1，2周时均有显著升高，第3周仍维持在较高水平。IL-10水平与血浆PGE2的升高呈显著正相关（r=0.878，P＜0.05 ） 。IL-2水平在BDL后1，2周时均有下降趋势,但无显著意义;第3周，IL-2水平则有显著下降，且与血浆PGE2 的升高呈显著负相关（r=-0.645，P＜0.05 ）。提示阻塞性黄疸大鼠存在细胞免疫功能受损的情况，其发生可能与血浆PGE2升高有关。     

当归对阻塞性黄疸患者淋巴细胞IL-2活性和IL-2R表达的影响

目的探讨围手术期当归对阻塞性黄疸患者细胞免疫功能的调节作用。方法用当归注射液围手术期对患者进行治疗（共14d）,观察其外周血淋巴细胞IL-2的活性及IL-2R表达的变化。结果阻塞性黄疸患者血淋巴细胞IL-2活性及IL-2R表达阳性率与正常人相比均明显下降（P〈0.01）。给予当归治疗后,发现术前其IL-2活性及IL-2R表达阳性率均明显升高（P〈0.01）,术后其IL-2活性及IL-2R表达阳性率与术前相比虽略有下降,但与用药前相比仍有明显升高（P〈0.01）。结论围手术期应用当归具有改善阻塞性黄疸患者细胞免疫功能状态的临床实用价值。     

消炎痛对阻塞性黄疸患者免疫功能的调节作用

研究阻塞性黄疸患者外周血淋巴细胞白细胞介素２活性和血浆中前列腺素Ｅ２水平的变化，同时观察了消炎痛对上述指标的影响。结果发现阻塞性黄疸患者血淋巴细胞白细胞介素２活性明显下降，而血浆中前列腺素Ｅ２水平明显升高，且两者之间有显著的相关关系。给阻塞性黄疸患者服用消炎痛，可以显著改善其血淋巴细胞白细胞介素２活性，降低其血浆中ＰＧＥ２水平，提示阻塞性黄疸患者存在着免疫功能障碍，消炎痛能够明显改善阻塞性黄疸患者     

甲氰咪呱对阻塞性黄疸大鼠的免疫调节作用

本文研究阻塞性黄疸大鼠脾脏淋巴细胞白细胞介素2生成能力及抑制性T淋巴细胞活性的变化;同时观察甲氰咪呱对阻塞性黄疸大鼠免疫功能的影响,结果发现胆管结扎大鼠脾脏淋巴细胞白细胞介素2生成能力明显下降,抑制性T淋巴细胞活性明显增强;应用甲氰咪呱治疗胆管结扎大鼠,可明显改善其淋巴细胞白细胞介素2的生成能力,降低抑制性T淋巴细胞的活性。阻塞性黄疸患者免疫功能异常可能是其围手术期易感性增高的原因之一,甲氰咪呱能够明显改善阻塞性黄疸大鼠的免疫功能,有可能成为临床上提高阻塞性黄疸病人抗感染力有价值的药物之一。     

谷氨酰胺对阻塞性黄疸大鼠免疫功能的影响

目的 探讨谷氨酰胺对阻塞性黄疸大鼠免疫功能的影响和机理。方法 健康雄性Wistar大鼠50只，按随机数字表随机分成空白对照组（n=10）、阻塞性黄疸组（n=20）和谷氨酰胺治疗组（n=20）。血清TNF-α和IL-10水平测定用放射免疫法，肝功能用自动生化分析仪测定，同时检测细菌移位情况。结果 阻塞性黄疸组在制模后1、2周血清TNF-α较空白对照组明显下降，血清IL-10水平、TBIL、ALT及AST较空白对照组明显升高；而在应用谷氨酰胺后1、2周血清TNF-α较空白对照组和阻塞性黄疸组有明显升高，IL-10、TBIL、ALT及AST较阻塞性黄疸组明显下降，细菌移位较阻塞性黄疸组也明显减少。结论 谷氨酰胺能够改变阻塞性黄疸大鼠血清TNFa、IL-10功能的变化，增强大鼠免疫功能，减少肠道细菌移位。     

当归对阻塞性黄疸患者围手术期的免疫调节作用

探讨当归在临床上围手术期对阻塞性黄疸患者的免疫调节作用。方法：观察了阻塞性黄疸患者外周血淋巴细胞ＩＬ－２活性及ＩＬ－２Ｒ表达的改变，且围手术期应用当归注射液给予患者１４天治疗。结果：阻塞性黄疸患者血淋巴细胞ＩＬ－２活性及ＩＬ－２Ｒ表达均明显下降，围手术期应用当归治疗可明显提高患者ＩＬ－２活性及ＩＬ－２Ｒ的表达，并具有明显缓解手术介导的免疫抑制作用。结论：当归具有改善阻塞性黄疸患者免疫状态的临床应用     

肝癌外周血T淋巴细胞丝裂原反应性和血浆IL-2、IL-6活性及IL-2受体的表达

本文应用生物测定法检测了20例肝癌患者外周血T淋巴细胞丝裂原反应性和血浆白细胞介素2(IL-2)、白细胞介索6(IL-6)活性及可溶性白细胞介索2受体(IL-2R)的表达。结果表明，肝癌患者T淋巴细胞丝裂原反应性和血浆IL-2、IL-6活性均显著低于对照组．而IL-2表达却均显著高于对照组。结果提示，肝癌患者外周血T细胞功能被严重抑制．IL-2、IL-6、和IL-2R在该病的发病机制中可能起一定作用。     

PGE2和IL-2／IL-2R在胃癌患者手术前后的动态变化和相互关系

目的 探讨胃癌患外周血中白细胞介素2(IL-2)、白细胞介素2受体(sIL-2R)水平及CD25表达三手术前后的动态变化情况和相互关系,以及前列腺素E2(PCE2)与IL-2／IL-2R系统的关系。方法 分别采用ELISA法、^125I-RIA法及免疫荧光法对50例胃癌患手术前后外周血中IL-2、sIL-2R、PGE2水平及CD25表达进行检测。结果 胃癌患手术前后外周血中IL-2水平及CD25表达均低于对照组,而sIL-2R与PGE2水平均高于对照组;切除肿瘤后IL-2水平及CD25表达较术前升高,而sIL-2R及PGE2水平较术前下降;6例术后发生肿瘤转移或复发的患中,再次出现IL-2水平及CD25表达下降,而sIL-2R及PGE2水平上升,胃癌患术前IL-2水平与术前PGE2水平呈显负相关,术前sIL-2R水平与IL-2小平亦呈显负相关。结论 PGE2与sIL-2R参与了胃癌患术前存在的免疫抑制过程。非甾体抗炎药(NSAID）与外源性IL-2联合应用以预防胃癌转移或复发理论上具有可行性。     

肝癌、胃癌、大肠癌外周血T淋巴细胞丝裂原反应性和血浆IL-2、IL-6活性及IL-2受体的表达

目的 探讨肝癌、胃癌、大肠癌发病机理。方法 应用生物测定法检测肝癌、胃癌、大肠癌外周血T淋巴细胞丝裂原反应性和血浆白细胞介素-2(IL-2)、白细胞介素-6(IL-6)活性及可溶性白细胞介素-2受体(IL-2R)的表达。结果 肝癌、胃癌、大肠癌患者T淋巴细胞丝裂原反应性和血浆IL-2、IL-6活性均显著低于对照组．而IL-2R表达却均显著高于对照组。结论 肝癌、胃癌、大肠癌患者外周血T淋巴细胞功能被严重抑制．IL-2、IL-6和IL-2R可能在该病的发病机制中起一定作用。     

蛋白激酶C信息通道与阻塞性黄疸患者免疫功能评估的关系

目的研究蛋白激酶C(PKC)信息通道在阻塞性黄疸(阻黄 )患者机体发病机理中的作用. 方法从51例阻黄患者和16例正常对照者的外周静脉血中分离和纯化淋巴细胞胞浆及胞膜部分PKC,然后采用同位素(γ-32P-ATP催化活性测定法检测它们的活性. 结果(1)阻黄患者外周血淋巴细胞PKC的总活性较正常健康人明显增强(r=0.64, P＜0.01),且胞膜部分PKC活性占总活性的百分值较正常组也明显升高(r=0.63 ,P＜0.05) .(2)阻黄患者淋巴细胞PKC的活性与血清黄疸的程度(T-BIL)显著正相关(r=0.67,P＜0.01),与血清可溶性白介素-2受体(sIL-2R)浓度显著正相关(r=0.58,P＜0.01). 结论 PK C信息通道的激活与黄疸程度有关,且可能参与了阻黄T淋巴细胞的活化,在阻黄机体的免疫调节及病情评估中可能有重要意义.     

Changes in production of interleukin-1 and interleukin-2 associated with obstructive jaundice and biliary drainage in patients with gastrointestinal cancer

Increased susceptibility to infection in patients with obstructive jaundice has been well documented in vitro and in vivo. Nevertheless, an underlying mechanism for immunocompromise in these patients has not been identified. This study was undertaken to evaluate the production of two important immunoregulatory molecules, interleukin-1 (IL-1) and interleukin-2 (IL-2), by peripheral blood mononuclear cells in cancer patients with obstructive jaundice before and after percutaneous transhepatic biliary drainage (PTBD). After decompression with PTBD, IL-1 and IL-2 production was significantly increased (IL-1: from 7.9 +/- 4.9 to 13.9 +/- 4.9 U/ml, p less than 0.05; IL-2: from 8.8 +/- 4.9 to 14.1 +/- 6.5 U/ml, p less than 0.05). There was a positive correlation between IL-1 and IL-2 production (r = 0.424, p less than 0.05). The production of both interleukins correlated negatively with serum total bilirubin level (IL-1 r = -0.478, p less than 0.05; IL-2: r = -0.482, p less than 0.05) and positively with high-density lipoprotein cholesterol in serum (IL-1: r = 0.505, p less than 0.01; IL-2: r = 0.494, p less than 0.05). IL-2 production also correlated positively with serum albumin levels (r = 0.511, p less than 0.01). These results suggest that hyperbilirubinemia and abnormal lipid metabolism may be associated with impaired interleukin production, which may result in an increased susceptibility to infection during obstructive jaundice.     

恶性肿瘤引起的梗阻性黄疸患者手术前后细胞因子变化的意义

目的:探讨恶性肿瘤引起的梗阻性黄疸患者手术前后细胞因子的变化,揭示引起黄疸的炎症反应机制及其临床意义。方法:用酶联免疫吸附测定(ELISA)检测实验组(11例,由恶性肿瘤引起的梗阻性黄疸患者)、良性对照组(10例,由结石引起的梗阻性黄疸患者)及恶性对照组(6例,胆道恶性肿瘤未合并梗阻性黄疸患者)术前、术后血清白细胞介素Ⅳ(IL-6)及白细胞介素Ⅹ(IL-10)的水平。结果:实验组术前血清IL-6、IL-10水平明显高于术后,差异有显著性(P<0.05)。实验组及良性对照组血清IL-6、IL-10水平均高于恶性对照组,差异有显著性(P<0.05)。所有梗阻性黄疸患者血清中,IL-10水平与IL-6水平、体温、白细胞计数有关联,而与血清总胆红素无关联。结论:解除黄疸有助于患者机体免疫功能的恢复及中止机体抗炎反应,检测血清中细胞因子有助于判断疾病的转归情况。     

Study on mechanism of onset of endogenous endotoxemia during obstructive jaundice--with special reference to involvement of biliary infection

To clarify how biliary infections affect onset of endogenous endotoxemia during obstructive jaundice, I tried to review the clinical result of 104 cases of obstructive jaundice, and conducted a Limulus test of portal and peripheral blood in 20 cases of obstructive jaundice and an animal study using 38 rabbits. In cases of obstructive jaundice complicated by biliary infections, clinical improvement of jaundice became significantly unfavorable, and the outcome of surgical operation was significantly inferior to the cases without biliary infections. The endotoxin positive rate in the portal blood of obstructive jaundice was 65% (13 of 20 cases), among which 10 cases (79.6%) was also positive in the peripheral blood. Of these 10 cases, 7 cases manifested endogenous endotoxemia with no infectious focus, and prognosis of these cases was poor. The endotoxin positive rate in portal blood of obstructive jaundice group was also significantly higher than that of non-jaundice group in animal study, and when the reticuloendothelial system was blocked, the endotoxin positive rate in the peripheral blood showed an increasing tendency. In the animal group with experimental cholangitis, all the endotoxin positive animals in the portal blood were also positive in the peripheral blood. This result suggests that biliary infections accelerate a decrease in the reticuloendothelial function during obstructive jaundice. From these results, endogenous endotoxemia seems to affect the onset of various complications during obstructive jaundice and unfavorable prognosis.     

Impaired Kupffer cell function and effect of immunotherapy in obstructive jaundice

BACKGROUND: Obstructive jaundice is frequently associated with septic complications. This study examined the influence of biliary obstruction on bacterial clearance and translocation. The study focused on the phagocytic and killing activities of Kupffer cells and the preventive effect on bacterial translocation of OK-432, which is a hemolytic streptococcal preparation developed as a biological response modifier. METHODS: To study the mechanism of sepsis in obstructive jaundice, two groups of Wistar rats were examined: rats subjected to common bile duct ligation (CBDL) and rats subjected to a sham operation. Bacterial clearance, organ distribution, hepatic blood flow, and phagocytic function of Kupffer cells were examined. To evaluate the effect of OK-432 on bacterial translocation, rats were divided into three groups: sham operation + phosphate-buffered saline (PBS), CBDL + PBS, and CBDL + OK-432. RESULTS: In this study, clearance of Escherichia coli. from the peripheral blood in CBDL rats was decreased significantly compared with that in sham-operated rats. Significant decreases in E.coli trapped in the liver and in hepatic blood flow were observed in CBDL rats compared with sham-operated rats. Phagocytic activity and superoxide production of Kupffer cells isolated from CBDL rats were significantly lower than in sham-operated rats. The incidence of bacterial translocation in CBDL rats was increased significantly, and oral administration of OK-432 prevented it. CONCLUSION: The results suggest that susceptibility to infection in obstructive jaundice is due to impaired phagocytic function of Kupffer cells. Furthermore, obstructive jaundice promotes bacterial translocation, and OK-432 may be useful in preventing this translocation.     

中药黄芪对阻塞性黄疸大鼠细胞免疫功能的影响

目的 观察阻塞性黄疸大鼠细胞免疫功能的变化及中药黄芪对其细胞免疫功能的影响。方法：建立阻塞性黄疸大鼠模型,腹腔内注射黄芪（２５０ｍｇ／ｋｇ／ｄ）２周,测定血中Ｔ细胞表型ＣＤ３、ＣＤ４、ＣＤ８含量和血清白介素－２水平,并与对照组比较,结果 胆总管结扎３周后大鼠血中Ｔ细胞表型含量均有所下降,其中ＣＤ４减少相对更明显,血清 明显下降。腹腔注射黄苑２周可使大微ＣＤ３、ＣＤ４和ＣＤ８升高至接近正常,纠正ＩＬ     

Human lymphokine-activated killer cell activity. Role of IL-2, IL-4, and IL-7.

The T-cell growth factors interleukin 2 (IL-2) and interleukin 7 (IL-7) induce lymphokine-activated killer (LAK) cell activity in short-term cultures of human peripheral blood mononuclear cells. Interleukin 4 (IL-4), another T-cell growth factor, induces LAK cell activity in IL-2-prestimulated lymphocytes only and inhibits LAK cell generation in normal peripheral blood mononuclear cells. Our studies of the processes involved using 21-mer phosphorothioate antisense oligonucleotides to the sequence adjacent to the start codon of IL-2 mRNA or IL-4 mRNA (effective concentration, 5 to 10 mumol/L) and cyclosporine (0.01 to 1.0 microgram/mL) or FK506 (0.01 to 1.0 ng/mL) demonstrate that IL-7-induced LAK cell activity is independent of IL-2 production and is regulated by endogenously generated IL-4. Like IL-2, IL-7 stimulated production of tumor necrosis factor alpha, but we failed to detect interferon gamma in IL-7-stimulated cultures. The implication of this regulatory feedback in IL-7-induced LAK cell generation for clinical applications is discussed.     

Insulin response following intravenous glucose administration in dogs with obstructive jaundice

In order to further clarify the circulating insulin kinetics in obstructive jaundice, five anesthetized dogs were given a 15-min intravenous infusion of 1 g/kg glucose before and during the first 1 to 2 weeks after a common bile duct ligation. Significantly higher blood glucose levels, a lower insulin response in femoral vein blood, and a lower initial insulin response in portal vein blood were observed following glucose administration in the animals with jaundice. The ratio of (integrated portal insulin response-integrated femoral insulin response)/(integrated portal insulin response) was significantly increased in the animals with jaundice when compared with that of the control animals. These results suggest that a low peripheral insulin response following glucose administration in obstructive jaundice is induced by an augmented insulin extraction in the liver and/or peripheral tissue as well as by an insulin hyposecretion from the pancreas.