乌司他丁对婴幼儿体外循环细胞免疫功能的保护作用

Protective effects of ulinastatin on cellular immune function in infants underwent cardiac operations with cardiopulmonary bypass

目的 观察体外循环对婴幼儿T淋巴细胞免疫功能的影响,及乌司他丁对免疫功能的保护作用.方法 将湖南省儿童医院2010年1月至2010年6月收治的连续50例体重10 kg以下的室间隔缺损患儿随机分为两组,乌司他丁组和（U组）对照组（C组）,每组25例.U组在体外循环预充液中加入乌司他丁10 000 U/kg,C组未使用乌司他丁.选取CPB启动前、结束后1 h、1 d、7 d共4个时间点,采集静脉血以流式细胞仪行T淋巴细胞亚群分析.结果术后1 d U组CD4＋高于C组（P〈0.05）,CD3＋及CD4＋/CD8＋明显高于C组（P〈0.01）,CD8＋明显低于C组（P〈0.01）.术后7 d U组CD3＋、CD4＋、CD4＋/CD8＋明显高于C组（P〈0.01）.结论 体外循环可抑制婴幼儿T淋巴细胞免疫功能;乌司他丁能够改善体外循环造成的免疫抑制. 基金项目：本课题受湖南省自然科学基金资助（项目号06TJ41078）

Objective To observe the change of T lymphocyte immunity functions after cardiopulmonary bypass （CPB） in infants, and to evaluate the protective effects of ulinastatin on cellular immune function. Methods From Jan. 2010 to Jun. 2010, there were 50 infants with ventricular septal defects, whom divided randomly into the Ulinastatin group or Control, enrolled into this prospective trial. And infants from the ulinastatin group were treated with 1 000 U/kg which was added into the CPB priming fluid during the correct operations. Blood samples were taken at different time points for the analysis of T lymphocyte and its subtype by flow cytometry. Results 24 hours after the correct operations, and compared with the control group, infants from the ulinastatin group had higher levels of CD4^＋, CD3^＋ and CD4^＋/CD8^＋, as well as a lower level of CD8^＋. And 7 days late, the levels of CD4^＋, CD3^＋ and CD4^＋/CD8^＋ in the ulinastatin group were still higher than those in the control group. Conclusions Administration of ulinastatin in the CPB priming fluid can attenuate the inhibition of T lymphocyte immunity functions caused by CPB in infants.