术中输血对患者T淋巴细胞亚群的影响

INFLUENCE OF PERIOPERATIVE BLOOD TRANSFUSION ON PERIPHERAL BLOOD T LYMPHOCYTES SUBGROUP

目的 :研究术中输入异体全血和盐水、腺嘌呤、葡萄糖 -甘露醇处理后红细胞血 (SAG -M红细胞血 )后 ,患者外周血T淋巴细胞亚群的不同变化 ,总结输血对外周血T淋巴细胞亚群的影响 ,从而为临床合理输血提供实验依据。方法 :选择无严重并发症的乳癌根治术患者 30例 ,随机分为两组 :Ⅰ组 (n =1 5)为全血组 ,Ⅱ组为SAG -M红细胞血相 ,术中输血量均为 40 0ml,输入红细胞量相同。取 3个不同时相点 (术前、术后 1d及术后 5d)测定外周血中T淋巴细胞亚群 ,再统计分析其结果变化。结果 :两组术后CD3、CD4 、CD4 /CD8值与术前比较均显著性下降 (P <0 .0 1 ) ;而术后第 5天Ⅰ组的CD3、CD4 、CD4 /CD8值均较Ⅱ组显著降低 (P <0 .0 5)。结论 ;术中输入异体全血比输注SAG -M红细胞血对T淋巴细胞亚群的抑制更为显著 ,故要求术中尽量不输血 。

Objective:To study the changes in counts of peripheral blood T-lymphocyte subgroup after perioperative allogeneic whole-blood transfusion or erythrocyte suspention (SAG-Mblood) blood transfusion. Methods:Thirty patients undergoing elective resection for breast cancer were randomly allocated to receive 400ml of allogeneic whole-blood (n=15) or 400ml of SAG-M blood (n=15) during perioperative period. Consequently, we used Biotin-Streptavidin-Peroxidase to determine the counts of peripheral blood T-lymphocyte subgroup in pre-operation, 1 days and 5 days after operation. Results:The counts of CD 3?CD 4?CD 8 and CD 4/CD 8 decreased significantly after operation ( P <0.01). The decreases of CD 3?CD 4?CD 8 and CD 4/CD 8 in allogeneic whole-blood transfusion group were much more than those in SAG-M blood transfusion group 5 days after operation ( P <0.05). Conclusions:Perioperative blood transfusion contributes to the immunosuppression of peripheral blood T-lymphocyte subgroup, which is more serious after allogeneic whole-blood transfusion than after SAG-M blood transfusion. The component blood transfusion is superior to the whole-blood transfusion.