探讨灵芝孢子粉对肝细胞肝癌（肝癌）患者术后细胞免疫功能的影响。

本研究为前瞻性研究。选择2008年11月至2010年12月佛山市第一人民医院肝胆胰外科收治的70例肝癌肝切除患者。患者均签署知情同意书，符合医学伦理学规定。采用计算机随机数字表法将肝癌患者随机分为常规护肝治疗组（常规护肝组）和灵芝孢子粉治疗组（灵芝孢子粉组）。常规护肝组35例，其中男30例，女5例；年龄（51±10）岁。灵芝孢子粉组35例，男28例，女7例；年龄（50±9）岁。另选择35例健康体检者作为健康对照组。常规护肝组术后1 d开始给予复方甘草酸苷注射液+极化液；灵芝孢子粉组在常规护肝治疗的基础上，术后1 d开始口服灵芝孢子粉。分别于术前（或入组时）及术后1、7、28 d检测外周血分化群（CD）4⁺、CD8⁺、自然杀伤（NK）细胞。CD4⁺、CD8⁺、NK细胞百分率的比较采用t检验。

肝癌患者CD4⁺细胞百分率为（34±7）%，健康对照组为（43±7）%，肝癌患者较健康对照组明显降低（t=5.63，P<0.05）；肝癌患者CD8⁺细胞百分率为（30±3）%，健康对照组为（27±3）%，肝癌患者较健康对照组明显升高（t=4.83，P<0.05）；肝癌患者NK细胞百分率为（13±4）%，健康对照组为（19±5）%，肝癌患者较健康对照组明显降低（t=6.18，P<0.05）。常规护肝组肝癌患者术前的CD4⁺、CD8⁺及NK细胞百分率分别为（34±7）%、（30±4）%、（14±4）%，灵芝孢子粉组分别为（34±7）%、（31±3）%、（13±4）%，差异无统计学意义（t=0.00，1.18，1.05；P>0.05）。与术前相比，两组肝癌患者术后1 d的CD4⁺、CD8⁺及NK细胞百分率明显降低，差异有统计学意义（t=4.01，2.69，2.75；P<0.05）。灵芝孢子粉组术后7、28 d的CD4⁺细胞百分率与常规护肝组比较明显升高（t=3.70，2.39；P<0.05），CD8⁺细胞百分率明显降低（t=4.06，2.79；P<0.05），NK细胞百分率明显升高（t=2.79，2.09；P<0.05）。

肝癌患者术前及术后早期细胞免疫功能受到抑制，术后早期应用灵芝孢子粉可改善患者的细胞免疫抑制状态，有利于维护机体的免疫平衡。

To evaluate the effect of ganoderma lucidium spore (GLS) to the immunological function of patients with hepatocellular carcinoma (HCC) after operation.

A total of 70 HCC patients who underwent hepatectomy in the Hepatobiliary and Pancreatic Surgery of the First People's Hospital of Foshan from November 2008 and December 2010, were studied prospectively. The informed consents of all patients were obtained and the ethical committee approval was received. The patients were randomly divided into the conventional liver protection therapy group (conventional therapy group) and GLS therapy group using computer random number table method. There were 35 cases in the conventional therapy group, of which 30 were males and 5 were females with the mean age of (51±10) years old. There were 35 cases in the GLS therapy group, of which 28 were males, 7 were females with the mean age of (50±9) years old. Another 35 healthy person who received physical examination were enrolled as the control group. Patients in the conventional therapy group began to take compound glycyrrhizin and GIK injection one day after hepatectomy. Patients in the GLS therapy group were given ganoderma lucidum spores orally upon the basic of conventional therapy one day after hepatectomy. Detections of cluster differentiation (CD)4⁺, CD8⁺ and natural killer (NK) cells in peripheral blood were undertook preoperatively (or when enrolled in the study), and 1, 7 and 28 days after the operation. Comparisons of percentage of CD4⁺, CD8⁺ and NK cells between 2 groups were performed using t test.

Percentage of CD4⁺ cells in HCC patients[ (34±7) %] reduced significantly, compared with the control group[ (43±7) %] (t=5.63, P<0.05) . Percentage of CD8⁺ cells in HCC patients [ (30±3) %] elevated significantly, compared with the control group [ (27±3) %] (t=4.83, P<0.05) . Percentage of NK cells in HCC patients [ (13±4) %] decreased significantly, compared with the control group [ (19±5) %] (t=6.18, P<0.05) . The percentages of CD4⁺、CD8⁺ and NK cells of patients before the operation were (34±7) %、(30±4) %、(14±4) % respectively in the conventional therapy group and (34±7) %、(31±3) %、(13±4) % in the GLS therapy group and there was no significantly difference between them (t=0.00, 1.18, 1.05; P>0.05). The percentages of CD4⁺、CD8⁺ and NK cells of patients in 2 groups decreased evidently one day after operation compared with the preoperative data (t= 4.01, 2.69, 2.75; P<0.01) . Compared with the conventional therapy group, the percentage of CD4⁺ in the GLS therapy group elevated significantly 7 and 28 days after operation (t=3.70, 2.39; P<0.05) , while the percentage of CD8⁺ decreased significantly (t=4.06, 2.79; P<0.05) , and the NK cells elevated significantly (t=2.79, 2.09; P<0.05) .

The cellular immunological function in patients with HCC is inhibited before and after the operation. Application of ganoderma lucidum spores early after the operation can improve the cellular immunological function and help to maintain the body immunological balance.