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中国癌症防治杂志

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不同干预措施对肝癌焦虑患者术后免疫抑酸性蛋白和白细胞介素-6的影响

游雪梅;莫新少;黎乐群;陈德凤;钟丽;陈似霞;   

  1. 广西医科大学第一附属医院肝胆外科;
  • 收稿日期:2010-03-25 修回日期:2010-03-25 出版日期:2010-03-25 发布日期:2010-03-25

The efficacy of different interventions on postoperative levels of immunosuppressive acidic protein and interleukin-6 in patient with anxiety and hepatocellular carcinoma

YOU Xue-mei,MO Xin-shao,LI Le-qun,et al.   

  1. (The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China
  • Received:2010-03-25 Revised:2010-03-25 Online:2010-03-25 Published:2010-03-25

摘要: 目的探讨不同干预措施对原发性肝癌焦虑患者术后免疫功能的影响。方法采用焦虑自评量表(SAS)对所有肝癌住院病人进行评估,筛选出焦虑组(A组)132例,在非焦虑病人中选择与焦虑组相匹配的132例作为对照组(B组)。按照随机数字表法再将A、B组分别分为心理干预+药物干预、心理干预、药物干预和未干预等4个亚组。比较A、B组术前及各亚组术前、术后1、4、7、14、30d免疫抑酸性蛋白(IAP)和IL-6的水平。结果焦虑组术前IAP和IL-6的水平明显高于非焦虑组,差异有统计学意义(P<0.01);术后焦虑各亚组中,心理干预+药物干预、心理干预组在术后第1、4、7、14、30天患者IAP和IL-6的水平低于单纯药物干预组及未干预组(P<0.05、P<0.01);术后非焦虑各亚组IAP和IL-6的水平差异无统计学意义(P>0.05)。结论肝癌患者术前焦虑直接参与机体免疫功能的抑制,并与手术打击存在协同抑制机体免疫功能,心理干预+药物干预及单纯心理干预均能调节患者术后机体免疫功能,促进疾病康复。

关键词: 原发性肝癌, 焦虑, 免疫功能, 免疫抑酸性蛋白, 白细胞介素-6

Abstract: Objective To explore the efficacy of different interventions on immune functions of the patients with anxiety and hepatocellular carcinoma(HCC) after operation.Methods Patients with HCC were assessed by self-rating anxiety scale(SAS),then 132 cases were selected into anxiety group(group A) and the matched 132 cases without anxiety were into the control group(group B).Group A and B were further randomly divided into four subgroups,namely psychological plus drug group,psychological group,drug group and non-intervention group.The levels of immunosuppressive acidic protein(IAP) and interleukin-6(IL-6) from each group before and 1-,4-,7-,14-,30-day after operation were compared.Results The preoperative levels of IAP and IL-6 in group A were significantly higher than that in group B,and the differences were statistically significant(P<0.01).Among the subgroups of groups A,the 1-,4-,7-,14-and 30-day postoperative levels of IAP and IL-6 were lower in psychological plus drug group and psychological group than that in drug group and non-intervention group(P<0.05 or P<0.01).Among the subgroups of group B,the differences of postoperative level of IAP and IL-6 were without statistically significant(P>0.05).Conclusions The preoperative anxiety of patient with HCC directly involves in suppression of immune function,and it has synergistic effect with surgery attack.Both of psychological intervention alone and psychological plus drug intervention can regulate patient's immune function and promote postoperative recovery.

Key words: Hepatocellular carcinoma, Anxiety, Immune function, Immunosuppressive acidic protein(IAP), Interleukin-6(IL-6)