摘要
目的 了解风湿性心脏病心瓣膜置换术患者术前免疫功能的变化。 方法 将 5 2例心瓣膜置换术患者作为心瓣膜置换术组 ,5 0例健康人作对照组。术前分别抽取空腹静脉血测定植物血凝素淋巴细胞转化率、淋巴细胞分化群分子 3阳性 T细胞 (CD3+ )、淋巴细胞分化群分子 4阳性 T细胞 (CD4+ )、淋巴细胞分化群分子 8阳性 T细胞(CD8+ )、中性粒细胞吞噬率和杀伤率、免疫球蛋白 G(Ig G)、免疫球蛋白 A(Ig A)、免疫球蛋白 M(Ig M)、免疫球蛋白 E(Ig E)、补体 3(C3)、补体 4(C4)和循环免疫复合物 (CIC)。 结果 心瓣膜置换术组术前的细胞免疫指标及 Ig E,C4均明显低于对照组 (P<0 .0 5或 P<0 .0 1) ,心瓣膜置换术组 Ig G,Ig A,C3和 CIC明显高于对照组 (P<0 .0 5或 P<0 .0 1)。Ig E与 CD4+呈相关关系 (r=- 0 .314,P<0 .0 5 ) ,C3与植物血凝素淋巴细胞转化率和中性粒细胞杀伤率呈相关关系 (r=0 .311和 r=0 .30 0 ,P<0 .0 5 ) ;CIC与 CD3+ ,CD4+ 和 CD8+ 呈相关关系 (r=0 .42 2 ,r=0 .311和 r=0 .391;P<0 .0 1,P<0 .0 5和 P<0 .0 1)。 结论 风湿性心脏病心瓣膜置换患者术前的免疫功能与正常人有明显差异 ,患者处于易感染状态 ,心外科医师应采取有效措施预防和治疗患者术前可能发生的感染。
Objective\ To study preoperative immune function in rheumatic heart disease patients undergoing valve replacement surgery surgery.\ Methods\ Fifty two patients with cardiac valve replacement set up the study group, 50 healthy people set up the control group. Before operation, peripheral blood sample was taken and heparinized to measure immune indices including phytohemagglutinin lymphocyte transformation rate, cluster of differentiation molecule 3 positive T cells, cluster of differentiation molecule 4 positive T cells, cluster of differentiation molecule 8 positive T cells, rate of phagocytosis and kill of neutrophil granules, immunoglobulin G, immunoglobulin A, immunoglobulin M, immunoglobulin E, complement 3, complement 4 and circulating immune complex.\ Results\ In study group, cellular immune function indecies and immunoglobulin E, complement 4 were significantly lower than those of control group ( P<0.05 or P<0.01) ; immunoglobulin G, immunoglobulin A, complement 3 and circulating immune complex were significantly higher than those of control group ( P<0.05 or P<0.01) . Immunoglobulin E correlates with cluster of differentiation molecule 4 positive T cells( r=-0.314,P<0 05) . Complement 3 correlates with phytohemagglutinin lymphocyte transformation rate and kill rate of neutrophil granules ( r=0.311,r=0.300, P< 0.05) . Circulating immune complex correlates with cluster of differentiation molecule 3 positive T cells,cluster of differentiation molecule 4 positive T cells and cluster of differentiation molecule 8 positive T cells ( r=0 422, r=0 311, r=0.391; P<0.01, P<0.05, P<0.01) . Conclusion\ Preoperative immune function in rheumatic heart disease patients undergoing valve replacement surgery was significantly different from that of healthy people. Patients are susceptible to infections. Heart surgeons must take effective methods to prevent and treat the preoperative infections.
出处
《中国胸心血管外科临床杂志》
2000年第2期77-79,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
风湿性心脏病
心瓣膜置换术
术前免疫功能
Rheumatic heart disease Cardiac valve replacement Preoperative immune function
