体外循环术后红细胞免疫功能的变化

CHANGES OF IMMUNE FUNCTION OF RED BLOOD CELLS AFTER CARDIOPULMONARY BYPASS

本文用红细胞SPA混合花环法对26例先心病和风心病患者体外循环手术前后的红细胞亚群进行了动态观察。结果发现,术后早期,未粘附免疫复合物的红细胞亚群和粘附免疫复合物的红细胞亚群的百分值低于术前水平,而C3b受体活性低的红细胞亚群的百分值高于术前水平,说明体外循环术后早期红细胞免疫功能失代偿性地降低。其原因可能与体外循环对红细胞的损伤以及血中红细胞免疫抑制因子升高有关。

Immune function of peripheral red blood cells (RBC) were studied in 26 patients underwent open heart surgery for congenital heart disease (CHD) and rheumatic heart disease (RHD). The measurements were made just before and 1st, 3rd, 7th and 14th day after cardiopulmonary bypass (CPB). BBC subsets were quantitated hy a mixed BBCSPA rosette technique and BBC immunological inhibitor activity (BIIA) by BIIA assay. Compared with preoperative values, in the early period after CPB (i.e.1st, 3rd, 7th day after CPB), rates of both RBC-C_3b receptor and RBC-SPA rosette formation were significantly lower, which decreased by 41.13% and 31.34% in CHD, and by 40.71% and 18.70% in BHD, respectively; the rate of mixed BBC rosette formation was also lower, which decreased by 41.82% in CHD and by 35.10% in RHD; rates of both null RBC and BBC-C_3b receptor rosette inhibition were significantly higher, which increased by 18.14% and 42.07% in CHD, and by 19.99% and 65.10% in RHD, respectively. RBC subsets and RIIA returned to the preoperative levels in the 14th day after CPB. It is concluded that decrease in the immune function of BBC after CPB might be caused by damage of RBC and increase of RIIA in blood which might in turn be factors for increased incidence of postoperative infection. Thus, attention should be payed to changes of immune function of RBC after CPB.