国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2012年
12期
819-820,857
,共3页
自体血回输%全髋关节置换术%CD4+T淋巴细胞%CD8+T淋巴细胞%自然杀伤细胞%白细胞介素-2%白细胞介素-6
自體血迴輸%全髖關節置換術%CD4+T淋巴細胞%CD8+T淋巴細胞%自然殺傷細胞%白細胞介素-2%白細胞介素-6
자체혈회수%전관관절치환술%CD4+T림파세포%CD8+T림파세포%자연살상세포%백세포개소-2%백세포개소-6
Auto-blood transfusion%Total hip replacement%CD4+%CD8+%Natural killer cell%Interleukin-2%Interleukin-6
目的 比较回收式自体血回输和异体血输血对全髋关节置换手术患者免疫功能的影响. 方法 选择50例全髋关节置换手术,随机数字表法分为自体血回输组(A组)和异体血输血组(B组),每组25例.术中根据血容量丢失情况分别用自体血回输及异体血输血,于麻醉前、输血后第2天和输血后第5天采用流式细胞仪测定血浆CD4+T淋巴细胞(CD4+)、CD8+T淋巴细胞(CDx+)、自然杀伤细胞(natural killer cell,NK)的比例以及白细胞介素(interleukin,IL)-2(IL-2)和白细胞介素-6(IL-6)的值.结果 B组输血后CD4+、CD8+、NK细胞、IL-2的值在第2天[(35±6)、(22±6)、(7±3)％、(523±407) ng/L]和第5天[(35±6)、(26±8)、(6±4)％、(442±376) ng/L]均低于术前[(40±8)、(28±9)、(9±4)％、(839±472)ng/L] (P＜0.05);A组输血后CD4+、CD8+的值在第5天[(39±8)、(27±9) ng/L]、NK细胞、IL-2的值在第2天[(8±4)％、(807±534) ng/L]和第5天[(8±4)％、(821±437) ng/L]均较术前有所下降,但差异无统计学意义(P＞0.05)；IL-6的值在第2天[(3198±698) ng/L]和第5天[(3076±703) ng/L]均较术前[(2593±784) ng/L]有所升高(P＜0.05). 结论 自体血回输对全髋关节置换手术患者细胞和体液免疫功能均无明显抑制作用,是安全、可靠的血液保护方式.
目的 比較迴收式自體血迴輸和異體血輸血對全髖關節置換手術患者免疫功能的影響. 方法 選擇50例全髖關節置換手術,隨機數字錶法分為自體血迴輸組(A組)和異體血輸血組(B組),每組25例.術中根據血容量丟失情況分彆用自體血迴輸及異體血輸血,于痳醉前、輸血後第2天和輸血後第5天採用流式細胞儀測定血漿CD4+T淋巴細胞(CD4+)、CD8+T淋巴細胞(CDx+)、自然殺傷細胞(natural killer cell,NK)的比例以及白細胞介素(interleukin,IL)-2(IL-2)和白細胞介素-6(IL-6)的值.結果 B組輸血後CD4+、CD8+、NK細胞、IL-2的值在第2天[(35±6)、(22±6)、(7±3)％、(523±407) ng/L]和第5天[(35±6)、(26±8)、(6±4)％、(442±376) ng/L]均低于術前[(40±8)、(28±9)、(9±4)％、(839±472)ng/L] (P＜0.05);A組輸血後CD4+、CD8+的值在第5天[(39±8)、(27±9) ng/L]、NK細胞、IL-2的值在第2天[(8±4)％、(807±534) ng/L]和第5天[(8±4)％、(821±437) ng/L]均較術前有所下降,但差異無統計學意義(P＞0.05)；IL-6的值在第2天[(3198±698) ng/L]和第5天[(3076±703) ng/L]均較術前[(2593±784) ng/L]有所升高(P＜0.05). 結論 自體血迴輸對全髖關節置換手術患者細胞和體液免疫功能均無明顯抑製作用,是安全、可靠的血液保護方式.
목적 비교회수식자체혈회수화이체혈수혈대전관관절치환수술환자면역공능적영향. 방법 선택50례전관관절치환수술,수궤수자표법분위자체혈회수조(A조)화이체혈수혈조(B조),매조25례.술중근거혈용량주실정황분별용자체혈회수급이체혈수혈,우마취전、수혈후제2천화수혈후제5천채용류식세포의측정혈장CD4+T림파세포(CD4+)、CD8+T림파세포(CDx+)、자연살상세포(natural killer cell,NK)적비례이급백세포개소(interleukin,IL)-2(IL-2)화백세포개소-6(IL-6)적치.결과 B조수혈후CD4+、CD8+、NK세포、IL-2적치재제2천[(35±6)、(22±6)、(7±3)％、(523±407) ng/L]화제5천[(35±6)、(26±8)、(6±4)％、(442±376) ng/L]균저우술전[(40±8)、(28±9)、(9±4)％、(839±472)ng/L] (P＜0.05);A조수혈후CD4+、CD8+적치재제5천[(39±8)、(27±9) ng/L]、NK세포、IL-2적치재제2천[(8±4)％、(807±534) ng/L]화제5천[(8±4)％、(821±437) ng/L]균교술전유소하강,단차이무통계학의의(P＞0.05)；IL-6적치재제2천[(3198±698) ng/L]화제5천[(3076±703) ng/L]균교술전[(2593±784) ng/L]유소승고(P＜0.05). 결론 자체혈회수대전관관절치환수술환자세포화체액면역공능균무명현억제작용,시안전、가고적혈액보호방식.
Objective To compare the effect of the immune function on orthopedics operation patients between the autoblood transfusion and variant-blood transfusion.Methods 50 patients with THR operation were randomly divided into two groups:A group (auto-blood transfusion:25) and B group (variant-blood group:25).The auto-blood or variant-blood transfusion would be transfused depends on intraoperative blood volume lost.The plasma levels of CD4+,CD8+,natural killer cell(NK),interleukin-2(IL-2) and interleukin-6(IL-6) were determined at the time of before anesthetizing,2 d after transfusion and 5 d after transfusion with flow cytometry.Results In group B the levels of CD4+,CD8+,NK cells and IL-2 values[(35±6),(22±6),(7±3)％,(523±407) ng/L],[(35±6),(26±8),(6±4)％,(442±376)ng/L] were lower than that[(40±8),(28±9),(9±4)％,(839±472)ng/L] of preoperative on post-transfusion for 2 d and 5 d (P＜0.05).In group A,CD4+ and CD8+[(39±8),(27±9) ng/L]of 2 d,NK cells,IL-2 values declined on the time of 2 d[(8±4)％,(807±534) ng/L]and 5 d[(8±4)％,(821±437) ng/L]of post-transfusion,but the difference was not statistically significant (P＞0.05); The value of IL-6 of 2 d [(3198±698) ng/L] and 5 d [(3076±703) ng/L] were increased compared with the preoperative [(2593±784) ng/L] (P＜0.05).Conciusions Auto-blood transfusion was a safe and reliable method of blood protection which had no obviously depressant effect on immune including cellular immune function and humoral immune function of patients with total hip replacement operation.
