摘要
目的 :体外循环心脏直视手术比其他手术更易影响病人的免疫功能 ,目前认为其具体机制包括 :手术创伤、体外循环中血细胞的破坏、非组织配型输血、心肌缺血再灌注损伤、低温以及炎性因子的释放。缺血预处理已证实有较强的心肌保护作用 ,是一种内源性保护方法。该研究旨在探讨缺血预处理与术后免疫功能之间的关系。方法 :将 2 0例体外循环心脏直视手术患者随机分成实验组及对照组 ,实验组采用 3’ - 3’缺血预处理方案 ,对照组不作缺血预处理。分别检测各病人术前、术后 1d、术后 4d以及术后 7d外周血中T辅助细胞 (CD+4 )、T抑制细胞 (CD+8)、CD+4 CD+8、免疫球蛋白IgG和IgM活性的水平。结果 :各例患者术后反应机体特异性免疫功能的指标均下降 ,T淋巴细胞以T辅助细胞下降明显。实验组T细胞亚群在术后 4d左右恢复正常 ,与对照组有明显差异 ;IgG和IgM的水平在术后 4d即接近正常 ,术后 7d完全恢复 ,与对照组有显著差异。结论 :CPB可减弱病人的免疫功能 。
Objective: Cardiopulmonary bypass heart operation can affect patients immunocompetence easier than other operations, the mechanism includes: operation injury, the damage of blood cells in the external circulation, non-histocompatibility blood-transfusion, myocardial ischemia reperfusion injury, low temperature and inflammation factor release. It is proved to be effective that pretreat of ischemia as an endogenous protection can protect the myocardial. Our research aim is discuss the relationship between pretreat of ischemia and the postoperation immunocompetence. Methods: 20 patients who accept the cardiopulmonary bypass heart operation and divided into test group and contrast group randomized, the test group used 3’-3’pretreat of ischemia, the randomized group did not. Measure the T helping cell (CD + 4), T suppreor cell (CD + 8), CD + 4/CD + 8, the level of immunoglobulin IgG and immunoglolulin IgM in the periphery blood at preoperation, postoperation one day, four days and seven days. Results: All levels reflect body specificity immunocompetence depressed postoperatively in every patient, especially the T helping cell (CD + 4). T cell subgroup became normal 4 days postoperatively in test group, which has significant difference with the contrast group; IgG IgM is nearly normal 4 days postoperatively and normal 7 days postoperatively, which has significant difference with the contrast group. Conclusions: As CPB can decrease patients immunocompetence, so the pretreat of Ischemia method is helpful to the recovery of patients’ postoperatively immunocompetence.
出处
《中国现代医学杂志》
CAS
CSCD
2000年第4期21-22,共2页
China Journal of Modern Medicine
关键词
缺血预处理
心转流
体外循环
心脏直视手术
Pertreat of Ischemia, cytoimmunity, Humrimmunity, Cardiopulmonary Thansperfusion
