摘要
目的观察结直肠癌患者围术期采用异体输血后免疫功能的变化,并分析异体输血对患者预后的影响。方法选取2016年10月至2020年8月中山大学附属第六医院115例行手术治疗的结直肠癌患者为研究对象进行回顾性分析,根据其围术期是否输血分为输血组(66例)和无输血组(49例)。输血组患者于围术期从血库调取红细胞或血浆进行异体输血治疗。比较两组患者的T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平及凝血功能。比较患者手术前后肿瘤相关标记物水平变化,比较两组患者总生存率。结果输血后,输血组患者的CD3^(+)、CD4^(+)百分比、CD4^(+)/CD8^(+)比值显著低于输血前,CD8^(+)百分比显著高于输血前(P<0.05);输血组患者CD3^(+)、CD4^(+)百分比、CD4^(+)/CD8^(+)比值均低于无输血组,CD8^(+)百分比高于无输血组(P<0.05);两组患者输血或补液前后凝血功能比较,差异无统计学意义(P>0.05);两组患者术前及术后肿瘤相关标记物阳性表达率比较,差异无统计学意义(P>0.05);生存资料随访截至2021年1月,输血组患者的总生存率为81.82%,无输血组为79.59%,两组比较,差异无统计学意义(HR=0.965,P=0.934,95%CI=0.413~2.253)。结论围术期异体输血会对患者T淋巴细胞亚群产生影响,损害患者免疫功能。临床医师应对患者的机体免疫状况进行综合评估后,确定是否需要进行异体输血,以减少患者免疫机制的损伤。
Objective To observe changes of immune function in patients with colorectal cancer after perioperative allogeneic transfusion and the effects of allogeneic transfusion on prognosis.Methods A total of 115 patients with colorectal cancer who underwent surgical treatment in The Sixth Affiliated Hospital,Sun Yat-sen University from October 2016 to August 2020 were selected as the research subjects for retrospective analysis,and were divided into transfusion group(66 cases)and non-transfusion group(49 cases)according to whether they received perioperative blood transfusion.The transfusion group was given perioperative allogeneic transfusion with red blood cells or plasma.Before and after transfusion,levels of T cell subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and coagulation function were detected.The changes of tumor related markers before and after surgery were compared,and the overall survival rate of the two groups was compared.Results After transfusion,the percentage of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the transfusion group was significantly lower than that before transfusion,and the percentage of CD8^(+)was significantly higher than that before transfusion(P<0.05).The percentage of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the transfusion group were lower than those in the non-transfusion group,while the percentage of CD8^(+)was higher than that in the non-transfusion group(P<0.05).There was no significant difference in coagulation function between two groups before and after transfusion or fluid infusion(P>0.05).There was no significant difference in the positive expression rates of tumor related markers between two groups before and after surgery(P>0.05).Follow-up of survival data up to January 2021,the overall survival rate of the transfused group was 81.82%,and that of the non-transfused group was 79.59%,with no statistically significant difference between the two groups(HR=0.965,P=0.934,95%CI=0.413~2.253).Conclusion Perioperative allogeneic transfusion can affect T lymphocyte subsets and impair immune fu
作者
王康龙
林国参
曾杨
WANG Kanglong;LIN Guoshen;Zeng Yang(Department of Blood Transfusion,The Sixth Affiliated Hospital,Sun Yat-sen University;Department of Small Intestinal Endoscopy,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong 510655,China)
出处
《大医生》
2022年第7期1-4,共4页
Doctor
关键词
结直肠癌
围术期输血
免疫功能
预后
Colorectal cancer
Perioperative transfusion
Immune function
Prognosis
