预存式自体输血对择期手术患者术后淋巴细胞亚群的影响

Effects of preoperative autologous blood donation on postoperativelymphocyte subsets in elective surgery patients

目的评价预存式自体输血对择期手术患者术后免疫功能的影响。方法选择本院2015年11月-2016年8月符合预存式自体输血指征的择期手术患者51名,分为自体血组(n=20):术前采集自体血、术中回输;异体血组(n=15):术前未预存自体血,术中输异体血。未输血组(n=16):术前未预存自体血,术中未输注异体血。分析比较3组患者术前、术后1 d和5 d CD3+、CD4+、CD8+、CD4+/CD8+和NK细胞的变化。结果术后1 d,CD3+(%)、CD4+(%)及NK细胞数(×109),自体血组较异体血组与未输血组分别为59.81±5.82 vs 50.04±4.37 vs 56.28±5.56,31.06±5.77 vs 22.88±3.80 vs 29.00±2.77,0.17±0.06 vs 0.12±0.05 vs 0.17±0.05,自体血组较异体血组明显升高(P<0.05);术后5 d CD3+(%)、CD4+(%)、CD4/CD8、NK细胞比例(%)及绝对计数(×109),自体血组、异体血组与未输血组分别为69.56±6.02 vs 59.81±5.38 vs 67.93±7.89,42.91±6.08 vs 31.14±3.99 vs 43.40±3.31,1.73±0.36 vs 1.23±0.37 vs 1.77±0.46,12.53±4.33 vs 7.84±3.41 vs 12.11±3.72,0.21±0.11 vs 0.10±0.06 vs 0.18±0.06),自体血组较异体血组明显升高(P<0.05)。结论预存式自体输血较异体输血对于患者术后免疫功能影响较小,对细胞免疫功能有正向调节作用。

Objective To evaluate the effects of preoperative autologous blood donation on patient immunity function post operation. Methods Fiftyone elective surgerypatientswere chosen with a schedule rangefrom November,2015 to August,2016.Three groupswere formed： group A,20 patients,with preoperativeautologous blood donationand interoperationtransfusion; group B,15 patients,withonlyallogeneic blood sourcetransfusion during operation; group C,16 patients,with no transfusion involved.The changes of CD3^＋,CD4^＋,CD8^＋T cells,CD4^＋/CD8^＋,and NK cells in the three groups were analyzedonday1 and day 5 post operation.Results CD3＋（ %）,CD4^＋（ %）,CD8^＋（ %）,CD4^＋/CD8^＋and NK（ ×10^9） cells in group A on postoperative day 1 were significantly higher than those in group B（ P 0. 05） whileno significant difference was found between group A and group C（ 59. 81±5. 82 vs 50. 04± 4. 37 vs 56. 28± 5. 56,31. 06± 5. 77 vs 22. 88 ± 3. 80 vs 29. 00 ± 2. 77,0. 17±0. 06 vs 0. 12±0. 05 vs 0. 17±0. 05）.All indexes of group A recovered to the preoperative level on postoperative day 5,CD3^＋（ %）,CD4^＋（ %）,CD4/CD8,NK cell ratio（ %） and absolute count（ ×10^9） were significantly higher than those in group B（ 69. 56±6. 02 vs 59. 81±5. 38 vs 67. 93±7. 89,42. 91±6. 08 vs 31. 14±3. 99 vs 43. 40±3. 31,1. 73±0. 36 vs 1. 23±0. 37 vs 1. 77±0. 46,12. 53± 4. 33 vs 7. 84 ± 3. 41 vs 12. 11 ± 3. 72,0. 21 ± 0. 11 vs 0. 10 ± 0. 06 vs 0. 18 ± 0. 06）,P 0. 05.Conclusion The preoperative autologous blood donationfrom patientspossessed less impact on the postoperative immune function,and presented a positive effect on cellular immune function.