摘要
目的 探讨成份输血对食管癌、直肠癌病人术后Ｔ淋巴细胞亚群及自然杀伤细胞的影响。方法 ２４例食管癌和２４例直肠癌病人，分别随机分为四组，输盐水组（Ⅰ组），输压积红细胞组（Ⅱ组），输全血组（Ⅲ组），输血浆组（Ⅳ组），每组 １２例，分别于术前、术后第 １、５、１０、１５ 天测定外周血Ｔ淋巴细胞亚群（ＣＤ３＋、ＣＤ４＋、ＣＤ８＋），（ＣＤ３＋＋ＣＤ４＋）／（ＣＤ３＋＋ＣＤ８＋）比值及自然杀伤细胞（ＣＤ１６＋５６＋）的变化。结果 与术前相比，术后第１天四组病人ＣＤ３＋、ＣＤ４＋、ＣＤ８＋、（ＣＤ３＋＋ＣＤ４＋）／（ＣＤ３＋＋ＣＤ８＋）、ＣＤ１６＋５６＋显著降低（Ｐ＜０．０５或 ０．０１）；术后第 ５天输全血组和输血浆组ＣＤ３＋、ＣＤ４＋、ＣＤ８＋、ＣＤ１６＋５６＋显著降低（Ｐ＜０．０５），输盐水组及输压积红细胞组各项指标均无显著变化（Ｐ＞０．０５）；术后第１０天输全血组和输血浆组，ＣＤ１６＋５６＋仍较低（Ｐ＜０．０５）。组间比较：术后第１天输全血组和输血浆组ＣＤ１６＋５６＋显著低于输盐水组（Ｐ＜０．０５）；术后第 ５天输血浆组 ＣＤ４＋显著低于输压积红细胞组（Ｐ＜０．０５）。结论食管癌和直肠癌病人术后可出现一个可逆性细胞免疫功?
Objective It has been shown that perioperative allogenic blood transfusion inhibits immunofunction of cancer patients and may lead to recurrence of cancer and increase in infection rate, but blood transfusion is often inevitable. The purpose of this study was to evaluate the effects of component blood transfusion on postoperative changes in T-lymphocyte subsets and NK cell in patients with esophagus or rectum cancer.Methods Twenty -four patients with esophagus cancer and twenty-four patients with rectum cancer were randomly assigned to one of the four groups of 12 patients each: group I received only normal saline and Ringer's lactate solution ; group II packed red cells 2-4 units; group M whole blood 400-600 ml and group N plasma 400-600ml. Preoperative Hb of all patients was over llOg/L. Patients with endocrine, immunological, liver or kidney disease and those who had receive radio- or chemotherapy were excluded. No cortical hormone was used during perioperative period, trying to avoid its effec t on immunological function and no patient received allogenic blood transfusion after operation. The patients were premedicated with phenobarbital 0.1 and atropine 0.5mg. Anethesia was induced with fentanyi 0.1-0.2mg, midazolam 0.1-0.2mg ?kg'1 and succinylcholine lOOmg and maintained with isoflurane and intermittent IV boluses of fentanyi and vecuromium. Peripheral venous blood samples were taken before operation and on 1st , 5th, 10th and 15th postoperative day for determination of subsets of T-lymphocyte CD3+, CD4+, CD8+, (CD3+ + CD4+)/(CO3+ + CD8+ ) and natural killer cell (CD16+56+) by flow cytometer. Results 1. As compared with the baseline on 1st postoperative day CD3+ , CD4+, CD8+ , (CD3+ + CD4+ )/(CO3+ +CD8+ ) and CD16+56+ all decreased significantly in the four groups (P<0.05-0.01); on 5th postop day CD3+ ,CD4+ , CD8+ and CD16+56+ decreased significantly in group III and IV(P<0.05); on 10th day CD/stse were still significantly lower than the baseline in group ffl and IV(P<0.05) .2. As compared betw een the grou
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2001年第12期721-723,共3页
Chinese Journal of Anesthesiology
关键词
T淋巴细胞亚群
天然杀伤细胞
血液成份输血
食管肿瘤
直肠肿瘤
T Lymphocytes
Killer cell, natural
Blood component transfusion
Neoplasmas in group I and ll
on 5th day cD was significant1y lower in group IV than that in group ll (P< 0.05). Conclusions There is a reversible inhibition of ce1lular immunity
