摘要
目的探讨输入异体全血和盐水、腺嘌呤、葡萄糖－甘露醇处理后红细胞血（ＳＡＧ－Ｍ红细胞血）后，Ｔ淋巴细胞亚群、ＮＫ细胞数量和血清可溶性白介素２受体（ｓＩＬ－２Ｒ）水平的变化，为临床合理输血提供实验依据。方法直肠癌根治手术患者３０例，随机分为２组Ⅰ组（ｎ＝１５）术中输血为异体全血；Ⅱ组（ｎ＝１５）术中输血为ＳＡＧ－Ｍ红细胞血，术中输血量均为４００ｍｌ。用间接免疫荧光法和双抗夹心ＥＬＩＳＡ法，检测术前、术后第１天和术后第５天Ｔ淋巴细胞亚群、ＮＫ细胞数量及血清ｓＩＬ－２Ｒ水平。结果两组术后 ＣＤ３＋、ＣＤ４＋细胞、ＮＫ细胞与术前比较均有显著性下降（ Ｐ＜ ０．０１ ）；术后第 ５天 Ⅰ组 ＣＤ３＋、ＣＤ４＋细胞、ＮＫ细胞水平与 Ⅱ组比较显著性降低（Ｐ＜０．０５）。两组患者血清 ｓＩＬ－２Ｒ水平术后均显著性升高（Ｐ＜０．０１），Ⅰ组较Ⅱ组显著性升高（Ｐ＜０．０１）。Ⅰ组术后第１、５天ｓＩＬ－２Ｒ与 ＣＤ３＋。ＣＤ４＋细胞、ＮＫ细胞是显著性负相关（ｒ＝－０．５５、－ ０．５９、－ ０．６２， Ｐ＜０．０５）。结论围术期输异体全血比输ＳＡＧ－Ｍ红细胞血对免疫功能的抑制更为严重，应尽量少输血，必需输血时，推荐成份输血。
Objective To investigate the changes in counts of T-lymphocyte subsets, natural killer cell (NK cell) and the levels of serum soluble interleukin-2 receptor(sIL-2R) after perioperative allogeneic whole-blood transfusion or erythrocyte suspention (SAG-M blood) blood transfusion. Methods Thirty patients undergoing elective refection for rectal cancer, were randomly allocated to receiving 400 ml of allogeneic whole-blood (n = 15 ) or 400 ml of SAG-M blood (n = 15 ) during perioperative period, respectively. Indirect immunofluorescence technique and enzyme-linked immunosorbent assay were used to determine the counts of T--lymphocyte subsets, NK cells and to detect levels of serum sIL-2R 1 day and 5 day after operation.Results The counts of CD3 +, CD. + and NK cells in both groups decreased significantly after operation (P < 0. 01 ). The decreases in counts of CD3 +, CD4 + and NK cells in allogeneic whole-blood transfusion group were much more than those in SAG-M blood transfusion group 5 day after operation (P< 0. 05). sIL-ZR level elevated greatly after operation(P< 0. 01 ), the increase of which was more obvious in allogeneic whole-blood transfusion group than in SAG-M blood transfusion group (P < 0.01 ). There were significantly negative correlations between sIL-2R level and counts of CD3+, CD4 + or NK cells after operation in allogeneic blood transfusion group(r = - 0. 55, - 0. 59 - 0. 62, P < 0 .05). Conclusions Perioperative blood transfusion contributes to the immunosuppression, which is more serious after whole-blood transfusions than after SAG-M blood transfusion. In perioperative period component blood transfusion is superior to whole-blood transfusion.
出处
《中华麻醉学杂志》
CSCD
北大核心
2000年第7期395-398,共4页
Chinese Journal of Anesthesiology
关键词
手术期间
输血
红细胞输注
T细胞亚群
NK
SIL-2R
Intraoperative period
Bloob transfusion
Erthrocyte transfusion
T-lymphocyte subsets
Killer cells
natural
Receptors
interieukin--2l
