摘要
目的比较急性非等容性血液稀释(ANIH)和急性高容性血液稀释(AHH)联合控制性降压(CH)对直肠癌患者T淋巴细胞亚群的影响.方法选择ASAⅠ～Ⅱ级,择期直肠癌根治术(Mile’s)患者45例,年龄38～67岁,体重50～78 kg,随机分为3组,每组15例,对照组(Ⅰ组,常规输液组),ANIH组(Ⅱ组),AHH+CH组(Ⅲ组).分别于麻醉前1 h(T)1、术毕即刻(T)2、术后第1天(T)3、第4天(T)4抽取静脉血,测定T淋巴细胞亚群的变化.结果与正常人群比较,T1时三组CD3+,CD4+,CD4+/CD8+均明显降低(P<0.05),CD8+增高(P<0.05),组间差异无统计学意义(P>0.05).与T1时比较,Ⅰ组T2、T3时CD3+、CD4+、CD4+/CD8+均显著降低(P<0.05);Ⅱ组、Ⅲ组仅T3时降低,与Ⅰ组相比差异有显著性(P<0.05),Ⅱ组、Ⅲ组间差异无统计学意义(P>0.05);T4时三组CD3+、CD4+均恢复至术前水平,但Ⅰ组CD4+/CD8+显著低于Ⅱ组、Ⅲ组(P<0.05).结论术前急性非等容量血液稀释(ANIH)与急性高容性血液稀释联合控制性降压均可改善围术期T淋巴细胞免疫功能.
Objective To evaluate the effects of acute non-normolvolemic hemodilution（ANIH）and acute hypervolemic hemodilution（AHH）combined with controlled hypotension（CH）on T-lymphocyte subsets in patients undergoing rectal cancer surgery.Methods 45 ASA Ⅰ～Ⅱpatients aged 38～67 yr,weighing 50～78 kg,undergoing elective rectal cancer surgery were randomly divided into three groups（n=15）：GroupⅠ,control group,GroupⅡ,acute non-normolvolemic hemodilution（ANIH）group and GroupⅢ,acute hypervolemic hemodilution combined with controlled hypotension（AHH＋CH）group.The venous blood samples were taken at 4 time points which were at 1 h before the anesthesia（T1）,at the end of the surgery（T2）,on the first day and the forth day after surgery（T3,T4）to measure T-lymphocyte subsets.Results Compared with normal value,CD3＋,CD4＋,CD4＋/CD8＋ in three groups were obviously decreased（P0.05）,but CD8＋ were obviously increased（P0.05）at 1 h before operation.Compared with that at T1 time poin,CD3＋,CD4＋,CD4＋/CD8＋ in group Ⅰdecreased at T2、T3 time point（P0.05）,but those in group Ⅱ、Ⅲdecreased obviously only at T3 time point（P0.05）,and there was significant difference between groupⅠand groupⅡ,Ⅲ（P0.05）.At T4 point,CD3＋,CD4＋,CD4＋/CD8＋ in three groups recovered,but CD4＋/CD8＋ in groupⅠ were obviously lower than that in groupⅡ,Ⅲ（P0.05）.Conclusion The immunity of rectal cancer patients are suppressed before operation.Acute hypervolemic hemodilution（AHH）combined with controlled hypotension（CH）and acute non-isovolemic hemodilution（ANIH）can improve the immunity of rectal cancer patients.
出处
《昆明医学院学报》
2011年第8期73-77,共5页
Journal of Kunming Medical College
关键词
血液稀释
免疫
T淋巴细胞
直肠癌
Hemodilution
Immunity
T-lymphocytes
Rectal cancer
