围手术期输血对脑肿瘤患者细胞免疫功能的影响

Infleuce of perioperative blood transfusion on cell immune function in patients with primary brain tumors

目的通过测定脑肿瘤患者围手术期输血对细胞免疫功能的影响,为临床脑肿瘤患者谨慎输血提供科学依据。方法64例行根治性切除术脑肿瘤患者,按照随机化原则,输血组46例,未输血组15例;健康对照组40例。三组均在术前、术后3d、14d、30d分别抽静脉血备检。应用流式细胞仪测定淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+T细胞比值及NK细胞。结果输血组输血前与健康对照组无显著性差异;术后3d与术前相比有显著性差异(P<0.05),术后第14天、30天与第3天相比无显著变化,但明显低于术前水平(P<0.05)。未输血组输血前与健康对照组亦无显著性差异;术后第3天该值明显减少(P<0.05或0.01),但CD8+变化不显著;术后第14天,基本恢复至术前水平。组间相比:术前及输血前细胞免疫无差异。术后第3天,未输血组CD3+、CD4+、CD8+、CD4+/CD8+T细胞比值与输血组比较(P<0.05),CD8+无差异。术后第14天、30天,未输血组CD3+T细胞、CD4+T细胞、CD8+、CD4+/CD8+T细胞比值、NK细胞明显高于输血组(P<0.05)。结论输血对脑肿瘤患者的细胞免疫功能有较强的抑制作用,因此临床上对该类患者的输血应慎重。

Objective Measuring the cell immune function after pre-operative transfusion, to provide scientific evidence for the cerebroma patients who received transfusion. Methods Sixty-four cerebroma patients about to operative randomly divided into transfusion group （46 cases） ,non-transfusion group （15 cases） and 40 healthy volunteers as control group. Vessel blood samples drawn pre-operation, 3 and 14 and 30 days after operation for measurement, Flow cytometer was used to measure the CD3^＋ T cells, CD4^＋ T cells, CD8^＋ T cells, CD4^＋/CD8^＋ T cells ratio and NK cells. Results There was no evident different between the transfusion group and control group before transfusion. Three days after operation, there was remarkable different （P〈0.05）, On 14 and 30 days after operation, there was no evident different to 3 days after operation. But lower than the level of pre-operation （P〈0.05）. There was no evident difference between the non-transfusion group and control group before transfusion and it had difference 3 days after operation. Change of CD8^＋ cells was not remarkable. It returned to the level of pre-operation14 days after operation. Difference between groups： there was no evident difference before operation and transfusion. 3 days after operation, CD3^＋ T cells, CD4^＋ T cells, CD8^＋T cells, and CD4^＋/CD8^＋ T cells ratio in the non-transfusion group were no evident difference to the transfusion group. 14 and 30 days, the levels in the non-transfusion group were remarkably higher than that of the transfusion group （P〈0.05）. Conclusion Blood transfusion can depress the cellular immune function of cerebroma patients and it should be cautious to these patients in clinical practice.