Influence Of Malignant Severe Obstructive Jaundice On Patient’s Immune Function And Treatment Effects Of Immunopotentiator

Objective To evaluate the influence of malignant severe obstructive jaundice(MSOJ) on patient,s immune function and the treatment effects of immunopotentiator.Methods From March,2010to July,2012,39patients with MSOJ(TBil>342μmol/L),20patients with malignant non-severe obstructive jaundice(TBil17.1~342μmol/L) and20patients with cholelithiasis and no obstructive jaundice (TBIL<17.1μmol/L) were enrolled in this study. The patients were divided into3groups: group A, no-jaundice control group(n=20); group B, malignant non-severe obstructivejaundice group (n=20); group C, MSOJ group (n=39). All the patients in group Cunderwent percutaneous transhepatic cholangiography and drainage (PTCD), and were subdivided into2groups: group C1, immunopotentiator treatment group(n=18),subcutaneous injection of thymosin α-11.6mg, starting from the day after PTCD,1/d,7d; group C2, non-immunopotentiator treatment group(n=21). Serum levels of cytokines（IL-2, IFN-α, TNF-α）, T lymphocyte subsets（CD3~+, CD4~+, CD8~+）and NK cells were detected and compared between different groups.Results In group C, the percentages of CD3~+, CD4~+,CD8~+,NK and the serum level of IL-2were lower than that in group A（P<0.05）; the percentages ofCD3~+and CD8~+and the serum level of IL-2were lower than that in group B（P<0.05）; the serum levels of TNF-α and IFN-α were higher than that in group Aand B（P<0.05）. The percentages of CD3~+and NK and the serum level of IL-2in group B were lower than that in group A（P<0.05）. There were no significant differences for the ratio of CD4~+/CD8~+between different groups. In group C1, The percentages of CD3~+and CD4~+,the ratio of CD4~+/CD8~+and the serum level of IL-2had an upward trend，the serum levels of TNF-α and IFN-α h ad a downward trend; the percentages of CD3~+and CD4~+were higher than that in group C2on the fifth day after thymosin α-1treatment（P<0.05）; CD4~+percentage, CD4/CD8~+ratio and the serum levels of IL-2and IFN-α were all higher than that in group C2on the seventh day after thymosin α-1treatment（P<0.05）,while the serum level of TNF-α was lower（P<0.05）.Conclusions1.Malignant obstructive jaundice weakens patient,s immune function remarkably. The damage is more obvious in the patients with severe jaundice.2. Immunopotentiator can improve the immune function in the patients withMSOJ.