Etiology and treatment of postoperative severe infections based on impaired host defense systems in patients with digestive organ cancers

消化器官肿瘤患者宿主防御系统受损导致术后严重感染的病因及治疗

• 批准号: 01480329
• 负责人: SAITO Takao
• 金额: $ 4.35万
• 依托单位: Oita Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1989
• 资助国家: 日本
• 起止时间: 1989 至 1991
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-01480329/
• 关键词: host defense; postoperative infections; pneumococcal polysaccharide; IgG2; intracellular Rilling; superoxide anion production; TNF-alpha; 1L-1beta; 好中球殺菌能; 抗体産生能; 単球貧食能; 単球サイトカイン産生能; 術後重症感染症; 消化器癌; MRSA; Superoxide anion産生能; Myeloperoxidas

Correlation between dysfunctions of polymorphonuclear neutrophils(PMN), monocytes and humoral immunity and postoperative infections was studied mainly in patients with esophageal cancer.1. Humoral immunityWhen antibody producing capacity against pneumococcal polysaccharides (PPS) was compared, the levels of anti PPS IgG was significantly lower in patients with infections than those without infections. Serum IgG2 levels which are knouwn to be correlated to anti PPS IgG were also significantly lower in those with infections. Those in whom anti PPS Ig was under 600 EU, or IgG2 was under 500 mg/dl seem to be risky for postoperative infections.2. Cytocidal function of PMNIntracellular killing activity (KI) was generally lower in patients with esophageal cancer while superoxide anion production (SOP) was significantly higher in patients with infections than those without such problems.3. MonocytesPhagocytic index was significantly lower in patients with esphageal cancer while the levels of SOP and cytokine production were significantly enhanced in patients with infections than those without such problems.4. Causes of dysfunctionDyofunctions of PMN and monocytes were associated with protein-calorie malnutrition and chronic obstructive pulmonary diseases.Thus, depressed levels of antibody-producing capacity prior surgery were important as a causative mechanism of postoperative infections in patients with esophageal cancer. Activation of PMN and monocytes was found as enhanced levels of SOP and cytokine-production in throse with postoperative infections and those measurements seemed to be beneficial as a predictive indicator of high-risk patients for postoperative infections.

本文主要研究了食管癌患者术后中性粒细胞（PMN）、单核细胞及体液免疫功能异常与术后感染的关系.体液免疫当比较肺炎球菌多糖（PPS）抗体产生能力时，感染患者的抗PPS IgG水平显著低于非感染患者。已知与抗PPS IgG相关的血清IgG 2水平在感染者中也显着降低。抗PPS IG低于600 EU或IgG 2低于500 mg/dl者可能有术后感染的危险. PMN的细胞杀伤功能食管癌患者的细胞内杀伤活性（KI）普遍较低，而感染患者的超氧阴离子产生（SOP）明显高于无感染者.单核细胞吞噬指数在食管癌患者中显著降低，而SOP水平和细胞因子的产生在有感染的患者中显著高于无感染者.功能障碍的原因PMN和单核细胞功能障碍与蛋白质-热量营养不良和慢性阻塞性肺疾病有关。因此，术前抗体产生能力降低是食管癌患者术后感染的重要致病机制。发现PMN和单核细胞的激活与术后感染中SOP和精氨酸产生水平的增加有关，这些测量结果似乎有助于作为术后感染高危患者的预测指标。

项目成果

斉藤 貴生: "食道癌手術後MRSA感染症" 中外医学社,

Takao Saito：“食道癌手术后MRSA感染”中外医学社，

Saito T, Shigemitsu Y, Kinoshita T, katsuta T, Shimoda K, Miyahara M, Kobayashi.: "Impaired neutrophil bactericidal activity correlates with the infection occurring after surgery for eso- phageal cancer." J. Surg. oncol.51. 159-163 (1992)

Saito T、Shigemitsu Y、Kinoshita T、katsuta T、Shimoda K、Miyahara M、Kobayashi：“中性粒细胞杀菌活性受损与食管癌手术后发生的感染相关。”

Saito T, Kuwahara A, Shimoda K, Miyahara M, Kobayashi M, Shimaoka A.: "Predicting operative mortality based on impairment of host defense mechanisms in patients with esophageal cancer." J. Surg. oncol.52. 1-8 (1993)

Saito T、Kuwahara A、Shimoda K、Miyahara M、Kobayashi M、Shimaoka A.：“根据食管癌患者宿主防御机制受损来预测手术死亡率。”

Saito T,Kuwahara A,Shimoda K,Kinoshita T,Shigemitsu Y,Miyahara M,Kobayashi M: "Enhanced immunoglobulin levels correlate with infectious complications after surgery in esphageal cancer" J.Surg.Oncol.46(1). 3-8 (1991)

Saito T、Kuwahara A、Shimoda K、Kinoshita T、Shigemitsu Y、Miyahara M、Kobayashi M：“免疫球蛋白水平增强与食管癌手术后感染性并发症相关”J.Surg.Oncol.46(1)。

Saito T,Kuwahara A,Kinoshita T,Shigemitsu Y: "Increases in immunoglobulin and complement in patients with esophageal or gastric cancer" Jpn.J.Surg.22. 2402-2409 (1992)

Saito T、Kuwahara A、Kinoshita T、Shigemitsu Y：“食管癌或胃癌患者的免疫球蛋白和补体增加”Jpn.J.Surg.22。