汤凯雯

    [摘要] 目的 探讨妇科恶性肿瘤腹腔镜术建立CO2气腹过程中的腹膜免疫因子变迁机制。 方法 选取广州医科大学附属肿瘤医院妇科恶性肿瘤患者64例。根据手术方式将其分为两组，观察组34例，行腹腔镜术；对照组30例，行传统开腹手术。采用流式细胞术测定术前术后外周血CD4+T淋巴细胞、NK细胞及CD4+CD25highCD127lowTreg水平；采用ELISA法检测术后腹膜免疫因子IL-6、TNF-β、TNF-α水平。 结果 经建立CO2气腹的腹腔镜术后1 d观察组患者外周血CD4+T 淋巴细胞、NK细胞水平显著低于对照组，而CD4+CD25highCD127lowTreg细胞水平显著高于对照组(P 0.05)；观察组腹膜免疫因子(IL-6、TNF-α)水平均显著低于对照组，而TNF-β水平显著高于对照组(P < 0.05)；CD4+CD25highCD127lowTreg水平与恶性肿瘤的临床分期相关，表现为Ⅱ～Ⅲ期患者显著高于Ⅰ期患者(P < 0.05)；经Pearson相关性分析发现：CD4+CD25highCD127lowTreg与IL-6、TNF-α水平呈负相关(r = -0.741、-0.695，P < 0.05)；CD4+CD25highCD127lowTreg与TNF-β呈正相关(r = 0.694，P < 0.05)。 结论 妇科恶性肿瘤腹腔镜术建立CO2气腹过程中可能通过抑制腹膜免疫因子IL-6、TNF-α水平或增加CD4+CD25highCD127lowTreg细胞水平的方式降低患者的免疫功能，随术后时间的延长患者免疫功能可恢复。

    [关键词] 妇科恶性肿瘤；腹腔镜术；气腹；腹膜；免疫因子

    [中图分类号] R737.3 [文献标识码] A [文章编号] 1673-7210(2014)10(b)-0004-04

    Mechanism of peritoneal immune factors change during establishing CO2 pneumoperitoneum in gynecological malignant tumor laparoscopy

    TANG Kaiwen

    Cancer Center of Guangzhou Medical University， Guangdong Province， Guangzhou 510095， China

    [Abstract] Objective To discuss the mechanism of peritoneal immune factors change during establishing CO2 pneumoperitoneum in gynecological malignant tumor laparoscopy. Methods 64 patients with malignant gynecological tumor in Cancer Center of Guangzhou Medical University were selected. According to the operation mode all patients were divided into two groups ......