白细胞滤器对术中自体血回输后促炎-抗炎细胞因子的影响

Effect of leukocyte deplection filter on pro-and anti-inflammatory cytokines after intraoperative autologous blood transfusion

目的观察白细胞滤器对髋关节置换术中自体血回输后促炎-抗炎细胞因子变化的影响。方法选取全麻下髋关节置换术患者30例,随机分为对照组(C组)和白细胞滤器组(LDF组)各15例。术中均使用自体血回吸收,回输时LDF组使用白细胞滤器,而C组不用,分别在麻醉前(T1)、手术开始后1 h(T2)、术毕(T3)、术后1 h(T4)及术后2 h(T5)抽取静脉血检测血清TNF-α、IL-1β、IL-6、IL-8、IL-10浓度。结果两组T2时TNF-α、IL-1β浓度高于T1时(P<0.01),两组T3、T4、T5时IL-6、IL-8、IL-10浓度高于T1时(P<0.01),LDF组T4、T5时IL-10浓度低于C组(P<0.05),LDF组T4、T5时IL-6、IL-8浓度高于C组(P<0.01)。结论白细胞滤器可以调节由于自体血回输所引发的免疫抑制反应。

Objective To observe the changes of pro-and anti-inflammatory cytokines in patients undergoing total hip replacement with intraoperative autologous blood transfusion. Methods Thirty patients undergoing total hip replacement by general anesthesia were randomly divided into 2 groups （n = 15 each） ： control group （C）, and leukocyte deplection filter （LDF）. Intraoperative blood salvage was used in every patient,and leukocyte deplection filter was used in group LDF during autologous blood transfusion, but not in group C. The serum levels of TNF-α, IL-1β, IL-6, IL-8 and IL-10 were measured before anesthesia（T1 ）, 1 hour after operation began（T2）,in the time of operation over（T3 ）, 1 hour after operation（T4 ） and 2 hour after operation（T5 ）. Results The level of TNF-α,IL-1β at T2 was higher than Ti in two groups（P〈0.05） ,and the level of IL-6,IL-8,IL-10 at Ta ,T4 ,T5 were higher than T1 in two groups（P〈0.01） ,the level of IL-10 of group LDF was lower than group C at T4 ,T5 （P〈0.05） ,then the level of IL-6 and IL-8 in group LDF was lower than in group C at T4 ,T5 （P〈0.01）. Conclusion Leukocyte deplection filter can modulate the immunosuppressive reaction from intraoperative autologous blood transfusion.