心脏停跳和不停跳体外循环手术对机体细胞免疫的影响

Effect on Patient's Cellular Immunity System of Beating Heart Surgery and Cardioplegia Surgery with Extracorporeal Circulation

目的研究体外循环心脏停跳和不停跳心内直视手术对机体细胞免疫影响的差异。方法60例风湿性二尖瓣瓣膜病变患者,随机分成不停跳组(实验组)和停跳组(对照组),其中实验组40例,对照组20例,分别于10个时点抽取静脉血,测定T细胞亚群及自然杀伤细胞(NK细胞)。结果两组总T淋巴细胞(CD 3+)、辅助T淋巴细胞(CD4+)、CD4+/抑制T淋巴细胞(CD8+)、NK细胞在体外循环后下降,CD8+上升,差异有统计学意义(P<0.05),实验组CD3+、CD4+、CD4+/CD8+、CD8+、NK细胞恢复较对照组快(P<0.05)。结论体外循环不停跳心内直视手术对机体细胞免疫影响显著小于心脏停跳手术。

OBJECTIVE To study the different of the effect on cellular immunity system in beating heart surgery and cardioplegia surgery with extracorporeal circulation （ECC）. METHODS Sixty patients suffered from rheumatic mitral disease were randomly divided into two groups： the trial group （beating heart surgery,40 cases） and the control group （cardioplegia surgery,20 cases）. Venous blood samples were collected at ten different time intervals to examine the levels of CD^3＋ ,CD^4＋ ,CD^8＋ ,NK cell. RESULTS The results showed thatCD^3＋、CD^4＋、CD^4＋/CD^8＋、CD^8＋、NK cell in both groups decreased significantly after ECC, CD^8＋ in both groups increased significantly after ECC, the level of CD^3＋、CD^4＋、CD^4＋/CD^8＋、CD^8＋、NK cell need less time to recover to normal level in trial group than that in control group during ECC. CONCLUSION The effect on cellular immunity system in beating heart surgery is less than cardioplegia surgery during ECC.