异体输血对消化道出血患者凝血功能、血小板及部分免疫功能的影响

Effects of allogeneic blood transfusion on blood coagulation function,platelet and partial immune function in patients with gastrointestinal bleeding

目的:探讨异体输血对消化道出血患者凝血功能血小板及部分免疫功能的影响。方法:选择消化性溃疡出血患者40例,血红蛋白65~75g/L,其中对照组患者20例,不给予输血治疗,试验组患者20例,给予输注少白红细胞2~4U,并分别于输血前、输血后1d抽取2组患者静脉血,检测患者凝血功能及外周血中自然杀伤细胞(NK)、IgG、IgA、IgM、CD3^+、CD4^+、CD8^+、CD4^+/CD8^+的变化情况。结果:输血后1d试验组患者,NK细胞、CD3^+、CD4^+、CD4^+/CD8^+较输血前显著减少(P<0.05);输血后1d,试验组患者IgG减少,差异有统计学意义(P<0.05),2组IgA、IgM变化不显著(P>0.05);输血前、输血后1d2组患者凝血功能及血小板指标变化均差异不显著(P>0.05)。结论:异体输血对纠正患者失血性贫血有疗效,但对患者免疫功能抑制明显;对于异体输血量在一定范围内的患者凝血功能无明显影响。

Objective.. To explore the influence of allogeneic blood transfusion blood on coagulation function and part of the immune function in the patients with gastrointestinal bleeding. Method.. Forty patients with peptic ulcer bleeding, whose hemoglobin were between 65 and 75 g/L, were divided into two groups. The control group in- cluded 20 cases, who did not receive blood transfusion treatment, while the experimental group included 20 pa- tients, who received less white and red blood cells infusion of 2 to 4 U. The blood coagulation function and the changes of the natural killer （NK） cells, IgG, IgA, IgM, CD3＋, CD4＋, CD^8＋, CD4＋/CD^8＋ in peripheral blood were detected before and after blood transfusion 1 day for two groups of patients. Result：At 1 d after blood trans- fusion, in the experimental group patients, NK cells, CD3＋ , CD4＋, CD4＋/CD^8＋ significantly reduced before blood transfusion（P〈0.05）, and IgG significantly reduced, which had significant difference（P〈0.05）, while IgA and IgM changes in the two groups was not significant. The changes of blood coagulation function and platelet in the two group patients were not significant before and after blood transfusion（P〉0.05）. Conclusion： Allogene- ic blood transfusion might have curative effect to correct blood loss in patients with anemia, but obviously suppress immune function of patients. Allogeneic blood transfusion might have no significant influence on blood coagulation function in patients who receive a certain range volume of allogeneic blood transfusion.