参附注射液对体外循环手术患者围术期机体免疫功能的影响

Effects of Shenfu Injection on Immune Function in Patients during Perioperative Cardiopulmonary Bypass

目的观察参附注射液对体外循环手术患者围术期白细胞、中性粒细胞、淋巴细胞总数,血清IgG、IgA、IgM、C3、C4水平,T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)的影响。方法将90例体外循环手术患者随机分为术前参附组(第1组)、术后参附组(第2组)、对照组(第3组)3组,每组30例;观察患者术前第1天、麻醉后(转机前)、停机即刻、术后第1天、第3天、第8天上述指标变化情况。结果与术前相比,白细胞及中性粒细胞总数停机即刻及术后1、3天明显升高,到第8天下降,但仍未恢复到术前水平,3组之间差异无显著性;淋巴细胞总数,血清IgG、IgA、IgM、C3、C4水平,T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)停机即刻及术后1、3天明显下降,术后第8天有一定程度恢复,其中第1、2组下降程度较对照组轻,术后恢复比对照组好。结论参附注射液能改善体外循环手术患者围术期的免疫功能,减轻术后发生感染的风险。

Objective To observe the effects of Shenfu Injection （SI） on immune function in patients during perioperative cardiopulmonary bypass （CPB）, Methods Ninety patients scheduled for CPB were randomly divided into 3 groups, the group A treated with SI before CPB, the group B treated with SI after CPB and the group C （the control group）, 30 cases in each group. Counts of leukocyte, neutrophil, lymphocyte and T lymphocyte subsets （CD3^＋ , CD4^＋ , CD8^＋ , CD4^＋/CD8^＋ ） and serum levels of IgG, IgA, IgM, C3 and C4 were investigated at different time-points, i, e. one day before CPB, immediately after anesthesia and finishing CPB, and the 1st, 3rd and 8th post-operational days. Results In all the three groups, counts of leukocyte and neutrophil rose immediately after CPB and the high level maintained on the 1st and 3rd post operational days, it somewhat lowered on the 8th day but still higher than that before operation, showing insignificant difference among the 3 groups. As for the other indexes, they declined obviously and immediately after CPB and began to restore on the 8th day to a certain extent, and the restoration were better in the group A and B, as the changes were milder, Conclusion SI could improve the immune function and reduce the risk of post operational infection in patients during perioperative CPB,