摘要
目的：通过检测心脏体外循环（ＣＰＢ）手术前后病人血清中可溶性白介素２－受体（ｓＩＬ－２Ｒ）、Ｔ细胞亚群、自然杀伤细胞（ＮＫ），观察分析心脏ＣＰＢ手术病人细胞免疫的影响及其临床意义。方法：选择２４例风心病择期换瓣病人，术前、ＣＰＢ１０分钟、ＣＰＢ２小时、术后第１天、３天、５天检测血清ｓＩＬ－２Ｒ水平、Ｔ细胞亚群及ＮＫ细胞活性。术后第１天血清ｓＩＬ－２Ｒ水平升高，ＣＯ４（辅助细胞）活性明显降低，ＣＤ４／ＣＤ８（辅助细胞／抑制细胞）比值下降，ＮＫ活性降低；并且ｓＩＬ－２Ｒ与ＣＤ４、ＮＫ活性呈负相关。结论：低温心脏ＣＰＢ手术对病人免疫机能有不良影响，临床应采取相应措施，改善术后病人的免疫机能。
Objective:The changes in peripheral blood soluble interleukin 2 receptor (sIL-2R) and lymphocyte subsets and natural killer cell (NK) activity were observed during and after CPB.Methods:We randomly selected 24 patients undergoing cardiac valve replacement,16 cases of whom were carried on MVR and 8 cases on BVR.Myocardial protection were achieved by cold blood cardioplegic solution infused every 30 minutes.Blood samples were withdrawn from peripheral vein before sternotomy,10 minutes and 2 hours following CPB,the first,the third,the fifth day after operation.Results:Mean CPB and aortic clamping durations were 115±33 minutes and 74±24 minutes,respectively;the lowest temperature of nasopharynx and rectum were 27.4±1.8℃ and 29.2±2.3℃,respectively.The levels of sIL 2R were higher than the baseline,meanwhile CD 4, NK activity and CD 4/CD 8 ratio were lower than the baseline on the first day after operation.Conclusion:Hypothemic CPB contributes to suppression of cell mediated immunity,which is obvious on the first and third day after operation.A correlative treatment should be given according to the changes of sIL 2R,lymphocyte subsets and natural killer cell activity after cardiac CPB operations.
出处
《中华麻醉学杂志》
CSCD
北大核心
1997年第1期7-9,共3页
Chinese Journal of Anesthesiology
关键词
体外循环
T-淋巴细胞
受体
白介素-2
Cardiopulmonary bypassT lymphocyteKiller cells
naturalReceptors
interleukin 2
Key words Cardiopulmonary bypassT lymphocyteKiller cells
naturalReceptors
interleukin 2
