急性等容性血液稀释对神经外科患者围术期血清IL-6与皮质醇和红细胞免疫粘附功能的影响

Influence of acute normovolemic haemodilution on serum IL-6, cortisol and erythrocyte immunity in neurosurgical patients perioperatively.

目的 观察急性等容性血液稀释 (ANH)对神经外科患者围术期应激性内分泌反应和红细胞免疫粘附功能的影响。方法 择期神经外科手术患者 30例 ,随机分为ANH组 (n =1 5 )和对照组 (n =1 5 ) ,分别于诱导前、切皮时、手术 1h和术毕取血测定血清IL 6、皮质醇浓度和红细胞C3b受体花环率 (C3bRR)和红细胞免疫复合物花环率 (ICR)。结果 两组患者手术 1h和术毕的血清IL 6、皮质醇浓度相比均无显著性差异 (P >0 .0 5 ) ;与对照组相比 ,ANH组的C3bRR于手术 1h和术毕均明显增高 (P <0 .0 5 ) ,ICR明显降低 (P <0 .0 5 )。结论 ANH对神经外科患者围术期的应激反应没有显著影响 。

Objective To study the effects of acute normovolemic haemodilution (ANH) on neuroendocrine and immune response to neurosurgery stress.Methods Thirty patients undergoing elective neurosurgery were randomly divide into ANH group and control group. The serum concentrations of IL 6 and cortisol, C 3b receptor flower ratio (C 3b RR) and immune complex flower ratio (ICR) of erythrocyte were measured before induction of anesthesia, before and 1 h after incision, in the end of operation respectively.Results One h after incision and in the end of operation, there were no significant differences in the serum concentations of IL 6 and cortisol between the two groups ( P > 0.05 ). Compared with control group, C 3b RR was increased markedly in ANH group during and after the operation, while the ICR decreased significantly at the same time ( P < 0.05 ).Conclusion ANH had no significant effect on the stress response to neurosurgery, but improved the immune function of erythrocyte markedly.