体外循环术后红细胞免疫功能变化及精氨酸对红细胞免疫的调节作用

Changes of erythrocyte immunity after cardiopulmonary bypass and immunomodulation of arginine

探讨精氨酸 (L- Arg)对体外循环 (CPB)术后患者红细胞 (RBC)免疫功能的调节作用。方法 :随机选择心肺分流术 (CPB)术后患者 60例 ,分为 L- Arg实验组和对照组 ,对两组患者术后外周血红细胞C3b受体花环率 (RBC- C3b RR)、红细胞免疫复合物花环率 (RBC- ICR)和循环免疫复合物 (CIC)的动态变化进行对比研究。结果 :实验组 RBC- C3b RR、RBC- ICR术后明显高于对照组 ,CIC于术后 2周恢复正常。结论 :围术期应用精氨酸可促进 CPB术后患者 RBC免疫功能的恢复。

Objective:To study the changes in peripheral blood red blood cell immune adherence(RBC C3bRR,RBC ICR)and circulating immune complex(CIC)in patients after cardiopulmonary bypass(CPB)procedure,and to demonstrate the influence of arginine on cell mediated and erythrocyte immunity after CPB.Methods:Sixty patients undergone CPB were randomly divided into two groups.The experimental group received 15g arginine every day by intravenous infusion from the immediate time post open heart operation to the postoperation day(POD)7,while the control group received the same quantity of glucose solution.The blood samples of all patients were examined on preoperation day 1,postoperation day 1,3,5,7,14 to measure RBC C3bRR,RBC ICR and CIC.Results:RBC C3bRR and RBC ICR in both groups decreased considerably after operation,but they were higher significantly in experiment group than that in control group from POD 5 to POD 14.CIC of all patients in both group increased after CPB,and there was no significant difference between two groups.CIC of experiment group recovered on POD 14,but CIC in control group did not yet.Conclusion:CPB causes transient depression of cellular erythrocyte immunity.The recovery of host immunity takes about 14 days.Arginine, which has nutritional and immunomodulatory functions,enhances the recovery of immunity after CPB.