中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2012年
2期
161-163
,共3页
川芎嗪%输血,自体%抗体生成
川芎嗪%輸血,自體%抗體生成
천궁진%수혈,자체%항체생성
TETRAMETHYLPYRAZINE%Blood transfusion,autologous%Antibody formation
目的 探讨川芎嗪对自体血回输患者围术期体液免疫功能的影响.方法 择期行脊柱手术患者60例,年龄20～60岁,体重50 ～ 75 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将患者随机分成2组(n=30),试验组:于收集自体血前30 min,经5 min静脉输注川芎嗪2mg/kg,并在回收血液的肝素盐水和洗涤盐水内加入川芎嗪,每500 ml加入川芎嗪25 mg;对照组不给予川芎嗪.于麻醉诱导前(T0)、术后1 h(T1)、1 d(T2)及5 d(T3)时取静脉血样,采用ELISA法测定血清免疫球蛋白(IgG、IgM)的浓度；记录手术时间、术中出血量、回输血量.结果 两组患者手术时间、术中出血量、回输血量比较差异无统计学意义(P＞ 0.05).与T0时比较,对照组T1～T3时血清IgG和IgM浓度降低,试验组T1、T2时血清IgG浓度降低(P＜0.05或0.01),T3时差异无统计学意义,T1～T3时血清IgM浓度差异无统计学意义(P＞0.05)；与对照组比较,试验组T2、T3时血清IgG浓度、T1～T3时血清IgM浓度升高(P ＜0.05或0.01).结论 川芎嗪可在一定程度上减轻自体血回输患者体液免疫抑制,改善体液免疫平衡状态.
目的 探討川芎嗪對自體血迴輸患者圍術期體液免疫功能的影響.方法 擇期行脊柱手術患者60例,年齡20～60歲,體重50 ～ 75 kg,ASA分級Ⅰ或Ⅱ級,採用隨機數字錶法,將患者隨機分成2組(n=30),試驗組:于收集自體血前30 min,經5 min靜脈輸註川芎嗪2mg/kg,併在迴收血液的肝素鹽水和洗滌鹽水內加入川芎嗪,每500 ml加入川芎嗪25 mg;對照組不給予川芎嗪.于痳醉誘導前(T0)、術後1 h(T1)、1 d(T2)及5 d(T3)時取靜脈血樣,採用ELISA法測定血清免疫毬蛋白(IgG、IgM)的濃度；記錄手術時間、術中齣血量、迴輸血量.結果 兩組患者手術時間、術中齣血量、迴輸血量比較差異無統計學意義(P＞ 0.05).與T0時比較,對照組T1～T3時血清IgG和IgM濃度降低,試驗組T1、T2時血清IgG濃度降低(P＜0.05或0.01),T3時差異無統計學意義,T1～T3時血清IgM濃度差異無統計學意義(P＞0.05)；與對照組比較,試驗組T2、T3時血清IgG濃度、T1～T3時血清IgM濃度升高(P ＜0.05或0.01).結論 川芎嗪可在一定程度上減輕自體血迴輸患者體液免疫抑製,改善體液免疫平衡狀態.
목적 탐토천궁진대자체혈회수환자위술기체액면역공능적영향.방법 택기행척주수술환자60례,년령20～60세,체중50 ～ 75 kg,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법,장환자수궤분성2조(n=30),시험조:우수집자체혈전30 min,경5 min정맥수주천궁진2mg/kg,병재회수혈액적간소염수화세조염수내가입천궁진,매500 ml가입천궁진25 mg;대조조불급여천궁진.우마취유도전(T0)、술후1 h(T1)、1 d(T2)급5 d(T3)시취정맥혈양,채용ELISA법측정혈청면역구단백(IgG、IgM)적농도；기록수술시간、술중출혈량、회수혈량.결과 량조환자수술시간、술중출혈량、회수혈량비교차이무통계학의의(P＞ 0.05).여T0시비교,대조조T1～T3시혈청IgG화IgM농도강저,시험조T1、T2시혈청IgG농도강저(P＜0.05혹0.01),T3시차이무통계학의의,T1～T3시혈청IgM농도차이무통계학의의(P＞0.05)；여대조조비교,시험조T2、T3시혈청IgG농도、T1～T3시혈청IgM농도승고(P ＜0.05혹0.01).결론 천궁진가재일정정도상감경자체혈회수환자체액면역억제,개선체액면역평형상태.
Objective To investigate the effect of tertamethylpyrazine on perioperative humoral immune function in patients required for autologous blood transfusion.Methods Sixty ASA Ⅰ or Ⅱ patients aged 20-60 yr weighing 50-75 kg undergoing elective spinal surgery were randomly divided into 2 groups ( n =30 each):test group and control group.In test group,tertamethylpyrazine 2 mg/kg was infused intravenously over 5 min at 30 min before the autologous blood was collected.Tertamethylpyrazine was added to the heparinized saline and washing saline at the same time (25 mg per 500 ml) until the final concentration reached 0.005 ％.Tertamethylpyrazine was not given in control group.Venous blood samples were taken before anesthesia induction (T0) and at 1 h after operation (T1),and on day 1 and 5 after operation (T2.3) for measurement of serum IgG and IgM concentrations by ELISA.The operation time,intraoperative blood loss and amount of salvaged blood reinfused were recorded.Results There was no significant difference in the operation time,intraoperative blood loss and amount of salvaged blood reinfused between the two groups (P ＞ 0.05).Compared with the baseline value at T0,serum IgG and IgM concentrations were significantly decreased at T1-3 in control group and the serum IgG concentration was significantly decreased at T1.2 in test group ( P ＜ 0.05 or 0.01 ).The serum IgG concentration at T2.3 and serum IgM concentration at T1-3 were significantly higher in test group than in control group ( P ＜ 0.05 or 0.01 ).Conclusion Tertamethylpyrazine can reduce humoral immunosuppression to some extent and improve the balance of humoral immunity in patients required for autologous blood transfusion.
