Why do anesthesia and surgical procedures deteriorate host defense ability in perioperative period?

为什么麻醉和外科手术会降低围手术期宿主的防御能力？

• 批准号: 09671587
• 负责人: OGAWA Ryo
• 金额: $ 2.37万
• 依托单位: Nippon Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671587/
• 关键词: Surgical stress; host defense inability; lypphocytepenia; apoptosis; TNF; 宿主防衛機能; リンパ球

The purpose of this study is to invetigate the mechanism by which host-defence inability has been produced in patients who underwent surgical treatment.The findings obtained are followed ; (1)The number of lymphcytes in periperal blood decreased after surgical procedures. The compositions of lymphocytes were separated into helper t-cells (CD4) and supressort-cells (CD8) by cyteflow metry. The ratio of CD4 and CD8 (CD4/CD8) decreased significantly after upper abdominal operations.(2) The lymphocytes were separated by centrifugation and cultured in a medium. Then the nuclear chromatin was stained by an indicator pigment. Microscopic examination revealed an increased fragmentation rate of nuclear chomatin in surgical patients.(3) The lymphocytes were incubated in a medium containing fas-antibody and the ratio of labelled cells were analysed, showing an increased staining in surgical patients.(4)The periphera bloods wete taken from postoperative patients to determine hormones such as cortisol and norepinephrine, and cytokines such as IL-I and TNF.The concentration of TNF in blood correlated very well to fragmentation rate of nuclear chromatin.Th results suggest that surgical invasion stimulate the destruction of peripheral lymphocytes by apoptotic process in postoperative perid.

本研究的目的是探讨接受手术治疗的患者产生宿主防御无力的机制。获得的结果如下： (1)手术后外周血淋巴细胞数量减少。通过细胞流式测定将淋巴细胞的组成分为辅助 T 细胞 (CD4) 和抑制分选细胞 (CD8)。上腹部手术后CD4与CD8的比值(CD4/CD8)明显下降。(2)离心分离淋巴细胞并在培养基中培养。然后用指示剂色素对核染色质进行染色。显微镜检查发现手术患者核染色质碎片率增加。(3)将淋巴细胞在含有fas抗体的培养基中孵育，分析标记细胞的比例，显示手术患者染色增加。(4)外周细胞从术后患者身上抽取血液来测定激素，例如皮质醇和去甲肾上腺素，以及细胞因子，例如IL-I和TNF。血液中TNF的浓度与核碎片率密切相关染色质.Th结果表明，手术侵入术后期间通过凋亡过程刺激外周淋巴细胞的破坏。

项目成果

小川龍: J.Anesth. 10.Supp. 787 (1998)

小川龙：J.Anesth 10.Supp.787 (1998)

小川龍: "侵襲制御の意議と展望" 日本歯科麻酔学会雑誌. 25・3. 315-319 (1997)

小川龙：“侵入性控制的考虑和展望”日本牙科麻醉学会杂志 25・3（1997 年）。

小川龍: "一酸化窒素による血管内皮細胞の障害" Journal of Anesthesia. 12・Suppl. 578 (1998)

小川龙：“一氧化氮引起的血管内皮细胞损伤”麻醉杂志 12·增刊 578（1998）。

Tadeda S et al: "The effects of preoperative high dose methylprednisolone in attenuating the metabolic response after oesophageal resection" Eur J Surg. 163(3). 511-517 (1997)

Tadeda S 等人：“术前高剂量甲基强的松龙对减弱食管切除术后代谢反应的影响”Eur J Surg。

TakedaS,OgawaR: "The effect of preoperative high dose methyl, prednisolone in atenuating the metabolic response after Oesphayeal resection" Enr J Surg. 163. 511-517 (1997)

TakedaS，OkawaR：“术前高剂量甲基泼尼松龙对减弱食管切除术后代谢反应的影响”Enr J Surg。