术中输入浓缩红细胞对食管癌患者术后免疫功能的影响

Effect on the Immune Function of Postoperation of Patients with Esophageal Carcinoma through Intraoperative Transfusion of Packed Red Blood Cells

目的:探讨食管癌患者术中输入浓缩红细胞对术后固有免疫及细胞免疫功能的影响。方法:采用流式细胞仪分别对65例食管癌患者术前、术后两周外周血NK细胞及T细胞含量进行测定;其中19例患者行术中输入异体浓缩红细胞4 U(输血组),46例患者未行术中输血(未输血组),对两组进行术前及术后外周血NK细胞及T细胞含量的比较。结果:输血组与未输血组术前外周血NK细胞及T细胞含量比较差异无统计学意义(P>0.05);输血组术后外周血NK细胞及T细胞含量分别为(11.670±4.311)%、(53.340±5.911)%,明显低于未输血组的(18.340±5.594)%、(63.180±6.397)%,P<0.05;并且明显低于输血组术前的(20.720±9.394)%、(61.500±10.048)%,P<0.05。未输血组外周血NK细胞及T细胞含量术前术后比较差异无统计学意义(P>0.05)。结论:术中输入异体浓缩红细胞可导致食管癌患者术后外周血NK细胞及T细胞的水平降低,而手术对其无影响,进而使患者固有免疫及细胞免疫功能降低,影响术后恢复,故临床手术中应该尽量避免输注浓缩红细胞。

Objective： To evaluate the effect of intraoperative transfusion of packed red blood cells （PRBCs） on postoperative innate and cellular immune function of patients with esophageal carcinoma. Methods： The peripheral blood NK and Tcells were detected by flow cytometry in 65 preoperative and postoperative patients with esophageal carcinoma, including 19 patients who had a transfusion of allogeneic packed reb blood cell 4u and 46 patients who did not got blood transfusion. The content of preoperative and postoperative peripheral blood NK and Tcells in two groups was com- pared respectively. Results ： There was no statistically significant difference compared between the content of the periph- eral blood NK and T cells in patients with and without preoperative blood transfusion （P 〉 0.05 ） ; The content of the peripheral blood NK and Tcells in patients with postoperative blood transfusion （ 11.67 ± 4.311 ） %, （ 53.34 ± 5.911 ） % was significantly lower than that in postoperative （18.34 ± 5. 594）%, （63.18 ± 6. 397 ）% （P 〈 0.05 ）, and significantly lower than patients with blood transfusion in preoperative content （20.72 ± 9. 394）%, （61.50 ± 10. 048）% （P 〈 0.05 ）. Conclusion： Intraoperative packed red blood cells transfusion can cause the decrease of the content of the peripheral blood NK and Tcells for patients with esophageal carcinoma, then lead to the decrease of innate and cellular im- mune function and delay of the recovery of postoperation. However, the surgery has no effect on it. So in the clinical practice, intraoperative packed red blood cells transfusion should not be advocated.