输注辐照血对肺癌患者免疫功能及安全性的影响

The immune function and safety effect of irradiated blood in the patients with lung cancer

目的观察输注辐照血对肺癌患者免疫功能及安全性的影响。方法选取需要进行手术的肺癌患者105例,按照随机数字表法分为辐照血组、普通血组和未输血组各35例。辐照血组手术期间输入辐照后的成分血,普通血组手术期间输注普通的成分血,未输血组仅进行单纯性手术,观察3组治疗后免疫功能的变化、输血相关性移植物抗宿主病(transfusion associated graft versus host disease,TA-GVHD)发生情况。结果 3组均顺利完成手术。3组T细胞亚群(CD4^+、CD8^+、CD4^+/CD8^+)、NK细胞、各免疫球蛋白(IgM、IgG、IgA)和补体(C3、C4)水平均呈先降低后升高趋势,辐照血组和未输血组术后7d各指标基本恢复正常,普通血组未达到术前水平,CD4^+、CD8^+、NK细胞、各免疫球蛋白(IgM、IgG、IgA)和补体(C3、C4)组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05);CD4^+/CD8^+时点间差异有统计学意义(P<0.05),组间、组间·时点间交互作用差异均无统计学意义(P>0.05)。输血1个月内,辐照血组及普通血组均无发生TA-GVHD的患者。结论输注辐照血对肺癌患者机体免疫功能无明显影响,是一种安全、合理、可行的输血方式,值得在临床推广应用。

Objective To detect the immune function and safety of irradiated blood in lung cancer patients.Methods One hundred and five patients were divided into irradiated group,conventional group and non-transfusion group.Irradiation group used irradiated blood in the operation,conventional group used regular blood,while the non-transfusion group without transfusion.Then the immune function and transfusion associated graft versus host disease(TAGVHD)in three groups were observed.Results The T cell subsets(CD4^+,CD8^+,CD4^+/CD8^+),NK cell,immunoglobulins(IgM,IgG,IgA)and complement(C3,C4)were all first lowered and then increased,the irradiation group and non-transfusion group returned to normal seven days after surgery.The conventional group did not reach the preoperative level.The CD4^+,CD8^+,NK cells,immunoglobulin(IgM,IgG,IgA)and complement(C3,C4)betewwn the groups,time points,groups·time points interaction were statistically significant(P<0.05).CD4^+/CD8^+in time points was significant difference(P<0.05),and there was no significant difference in interaction between groups and groups· time points(P>0.05).No patients with TA-GVHD were found in the irradiated blood group and normal blood group in 1 month.Conclusion The irradiated blood had no significant effect on immune function of the lung cancer patients,which was a safe and reasonable and feasible way for blood transfusion.