输血对食管癌手术患者免疫功能的影响

Effect of blood transfusion on immune function in patients with esophageal carcinoma after surgery.

目的探讨输血对食管癌手术患者免疫功能的影响。方法140例食管癌患者,随机分为手术中输血组(64例)和未输血组(76例),分别于手术前第1天及手术后第3、14天采取静脉血,采用ELISA法测定患者血清中CD4、CD8的含量;采用郭峰法测定血液中红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR)、肿瘤细胞花环率(TRR)水平。结果与正常人相比,食管癌患者手术中输血组与未输血组相比血清中CD4水平降低,CD8水平升高,CD4/CD8比值降低(P<0.01);输血组RBC-ICR较未输血组升高,RBC-C3bRR和TRR均较未输血组降低(P<0.01)。结论手术中输血可使食管癌患者手术后淋巴细胞和红细胞免疫功能减低。

Objective To explore the effect of blood transfusion on immune function in patients with esophageal carcinoma after operation. Methods 140 cases of esophageal carcinoma were randomized into blood transfusion group （ n = 64 ） and non-blood transfusion group （ n = 76 ）. Venous blood samples were taken at the first day before operation and at 3 and 14 days after operation, CD4 and CD8 levels were measured by ELISA; The RBC- C3bRR,RBC-ICR and TRR levels were detected by the method established by Guo Feng, Results CD4 level decreased in blood transfusion group compared with non-blood transfusion group while CD8 level increased and the ratio of CD4/CD8 decreased （P 〈 0, 01 ）, RBC-ICR level in blood transfusion group increased while RBC- C3bRR and TRR levels decreased compared with those of non-blood transfusion group （ P 〈 0. 01 ）, Conclusion Blood transfusion may aggravate the immune suppression in patients with esophageal carcinoma after esophagectomy,