经阴道与开腹子宫肌瘤剔除术对机体免疫功能影响的比较

摘要

Objective To study the influence of vaginal operations for uterine myomas on human immune function. Methods From May 2008 to December 2010, 40 patients received vaginal operation for uterine myomas, at the mean time 40 patients underwent abdominal operation as a control. The levels of lgC, IgM , IgA , CD3 +, CD4 + , CD8 + , CD4 + / CD8 + of each patient were measured before the operation, and 24 and 72 hours after the operation respectively. Results The levels of IgC, IgM, and IgA didn' t change significantly after vaginal operation ( P > 0.05 ) , while the levels of IgG and IgM decreased significantly at 24 hours after the operation in abdominal groups (P < 0. 05 ) , which was significantly different from the vaginal group ( P < 0. 05). The levels of IgC and IgM in the abdominal group returned to the preoperative levels at 72 hours postoperation (P >0.05). The levels of CD3 + and CD4 + decreased significantly at 24 hours in both the groups ( P < 0. 05 ) without significant difference between them ( P > 0. 05). In the vaginal group, the above measured all returned to the preoperative levels at 72 hours; however, the levels of CD4+ in abdominal group still remained at a lower level at 72 hours postoperation ( P < 0. 05). Conclusion Compared with abdominal operation, vaginal operation for uterine myomas cause less immunosuppression and thus helps the patient to recover better.%目的 探讨经阴道子宫肌瘤剔除术对机体免疫功能的影响. 方法 2008年5月～2010年12月选择经阴道与开腹子宫肌瘤剔除术各40例,测定2组术前、术后24 h和术后72 h机体免疫球蛋白IgG、IgM、IgA,T细胞亚群CD3+、CD4+、CD8+、CD4 +/CD8+. 结果 经阴道组手术前后免疫球蛋白差异无统计学意义(P＞0.05).开腹组术后24 h IgG、IgM较术前降低(P＜0.05),且显著低于经阴道组(P＜0.05),术后72 h恢复至术前水平(P＞0.05).2组术后24 h CD3+、CD4+均较术前下降(P＜0.05),但2组间比较差异无统计学意义(P＞0.05).术后72 h经阴道组CD3+、CD4+上升至接近术前水平(P＞0.05),而开腹组CD4+仍低于术前水平(P＜0.05),且显著低于经阴道组(P＜0.05). 结论 经阴道子宫肌瘤剔除术比开腹手术对机体免疫抑制小,有利于患者的恢复.