糖尿病对冠状动脉旁路移植术患者围术期免疫球蛋白及补体功能的影响

Influence of diabetes on immunoglobulin and complement in the perioperative of coronary artery bypass grafting patient

目的探讨糖尿病对行冠状动脉旁路移植术患者同术期免疫球蛋白及补体功能的影响。方法采用非随机临床对比研究选取2012年1-8月在潍坊市人民医院行冠状动脉旁路移植术合并2型糖尿病患者15例，另选取15例血糖正常者作为对照，分别于术前1天（T1）、手术结束后30min（T2）、术后第1天（T3）、术后第3天（T4）、术后第7天（T5）清晨采集静脉血送检，检测免疫球蛋白（IgG、IgA、IgM）及补体（C3、C4）值。结果①两组T1时比较，糖尿病组IgA、C3值明显高于正常组（P〈0．01），IgG值明显低于正常组（P〈0．05），IgM、C4比较差异无统计学意义。②两组术后IgG、IgA、IgM值于T2、T3、T4时较T1时均明显降低（P〈0．05或0．01），糖尿病组降幅更加明显（P〈0．05或0．01），两组均于T5时恢复术前水平。两组术后C3、C4值在T2、T3时较T1时均明显降低（P〈O．05或0．01），糖尿病组c3值降幅更加明显（P〈0．05或0．01），两组均于T4时恢复至术前水平，c4值术后降幅两组之间比较差异无统计学意义（P〉0．05）。结论糖尿病患者存在免疫功能紊乱及调节功能异常，与正常组相比术后免疫球蛋白及补体功能受到抑制更加明显。

Objective To review the influence of diabetes on immunoglobulin and complement in the pe- rioperative of coronary artery bypass grafting patient. Methods In this non-randomized control study. Fifteen pa- tients with type 2 diabetes who underwent CABG from January 2012 to August in Weifang City People＇s Hospital were enrolled, enroll fifteen cases of normal group as control. For each patient, peripheral blood were taken one day before operation（T1）, half an hour after operation（T2）, on the first（T3）, third （T4） and seventh day （T5） after operation respectively. The result of immunoglobulin （IgG, IgA, IgM）and complement （C3, C4） were recorded Results （1）For the diebetic patients. The levels of IgA, C3 were significantly higher and the levels of IgG were lower than those of normal control （P〈0.05 or 0.01 ） at time spots TI. The levels of IgM, C4 were not significantly different at time spots T1. （2）Compared with T1, the levels of IgG, IgA, IgM in both groups were sig- nificantly reduced （P〈0.05 or 0.01 ） at time spots T2, T3, T4. The drop of diebetic patients was more apparent （P〈0.05 or 0.01 ）. Almost all of the above returned to their preperational level at time spots T5. Compared with T1, the levels of C3, C4 in both groups were significantly reduced （P〈O.05 or 0.01 ） at time spots T2, T3. The drop of C3 in diebetic patients was more apparent （P〈0.05 or 0.01 ）. They returned to their preperational level at time spots T4. The level of C4 were not significantly different ＇after operation between two groups. Conclusion Patients with diabetes exist immune dysfunction and the abnormality of imnmnoregulation, compared with normal group, the function of immunoglobulin and complement is retrained more apparent.