|
|
Changes and its clinical significance of procalcitionin and T lymphocyte subsets in elderly patients with choledocholithiasis after open surgery |
LIU Haorun, LI Weimin, ZHAO Hongqiang,and XU Shuai |
Department of Hepatobiliary Surgery,No.309 Hospital of PLA, Beijing 100091,China |
|
|
Abstract Objective To investigate the influence on T lymphocyte subsets and change of procalcitonin after open surgery in elderly patients with choledocholithiasis. Methods Elderly and young patients received cholangiotomy, choledochotomy with T tube drainage or cholangiojejunostomy according to the type of choledocholithiasis.Periphery blood samples from patients were collected on preoperative 1day, and postoperative 1, 3, 7days. The levels of peripheral blood leukocytes, procalcitonin, T lymphocyte subsets were measured and compared in groups divided by age. Results The level of peripheral blood procalcitonin in elderly patients group was significantly higher than in younger patients group(P<0.05).Surgical stress leaded to the increase of procalcitonin in elderly patients group on postoperative 1, 3, 7 days and young group on postoperative 1 and 3 days than preoperative level(P<0.05). Level of CD3+ T cells significantly reduced in elderly group than in young group(P<0.05), the levels of CD3+ T cells were obviously lower in postoperative 3 d than preoperative level (P<0.05).The level of CD8+ T cells on preoperative day and postoperative 7 day in elderly group were significantly lower than in younger group(P<0.05).The level of CD4+ T cells on preoperative day and postoperative 1,7 days in elderly group were significantly lower than in younger group(P<0.05),level of postoperative day 3 in elderly patients were distinctly reduced than preoperative day(P<0.05),level of postoperative day 7 in young patients were distinctly reduced than preoperative day(P<0.05).The ratio of CD4+/CD8+ on preoperative day and postoperative days 1,3,7 in elderly group were significantly lower than in younger group(P<0.05), level of postoperative day 3 in elderly patients were distinctly reduced than preoperative day(P<0.05). Conclusions Procalcitionin in elderly group is higher than in younger group. T lymphocyte subsets are lower. Differences in immune function changes exist between elderly and young choledocholithiasis patients undergoing open surgery.
|
Received: 05 June 2015
|
|
|
|
|
[1] |
任仰科.老年急性胆囊炎的治疗体会[J].中国社区医师:医学专业,2013,15(7):46.
|
[2] |
Krawczyk M,Stokes C S,Lammert F.genetics and treatment of bile duct stones: new approaches[J].Curr Opin Gastroenterol, 2013,29(3):329-335.
|
[3] |
黄志强.当代胆道外科学[M].上海:科学技术文献出版社,1998:361-379.
|
[4] |
孙绍春.老年胆道疾病特征分析及外科处理探讨[J].中国医药指南,2010,6(8):130-131.
|
[5] |
钟记华,王 斌,刘 彪.老年胆道结石救治探讨[J].当代医学,2009,3(15):83-84.
|
[6] |
郭黎英.PTC、hs-CRP、SAA检测在脓毒血症早期诊断的临床应用价值分析[J].中国现代药物应用,2015,4(9):23-24.
|
[7] |
伍方红,徐得泽,韦继政,等.降钙素原与C反应蛋白检测在术后重度脓毒血症患者预后判断中的意义[J].广东医学,2013,34(9):1369-1371.
|
[8] |
马 静,李红兵,张炜捷,等.血清降钙素原、超敏C反应蛋白在肺炎合并脓毒症患者中的意义[J].中国实用医药,2014,9(5):124-125.
|
[9] |
陈媛飞,何浩然.降钙素原在肝硬化合并自发性细菌性腹膜炎中的检测意[J].当代医学,2012,18(17):7-8.
|
[10] |
Fessler J, Ficjan A, Duftner C, et al.The impact of aging on regulatory T-cells. Front Immunol 2013,4:231.
|
[11] |
Zanetti M,Castiglioni P, Ingulli E.Principles of memory CD8 T cells generation in relation to protective immunity[J].Adv Exp Med Biol,2010,684:108-125.
|
[12] |
Story D A, Leslie K, Myles P S,et al. Complications and mortality in older surgical patients in Australia and New Zealand : amulticentre, prospective, observational study[J].Anaesthesia,2010,65: 1022-1030.
|
|
|
|