单采自体红细胞前后患者WBC参数和T/B/NK淋巴细胞水平的观察

Observation of white blood cells parameters and level of T/B/NK lymphocytes in patients before and after apheresis autologous red blood cells

目的:探讨单采自体红细胞对择期手术患者白细胞(WBC)计数、分类比值以及T/B/NK淋巴细胞水平的影响。方法:采用血细胞分析仪和流式细胞术分别测定26例择期手术患者单采自体红细胞前与后WBC参数和T/B/NK淋巴细胞水平。结果:与单采前相比,单采自体红细胞后患者的WBC、中性粒细胞和淋巴细胞的数量均下降(P<0.01),24例WBC下降后的值在正常范围内,2例低于正常值下限;患者WBC的倍数改变(倍数改变=单采前WBC计数/单采后WBC计数)分别与其身体质量指数(BMI)、血容量和单采前WBC计数无相关性(r=−0.1130,P=0.5826;r=0.1187,P=0.6033;r=0.0065,P=0.9747);与单采前相比,单采后患者中性粒细胞、淋巴细胞、CD4^(+)T细胞、CD8^(+)T细胞、B细胞和NK细胞的百分率均无显著变化(P>0.05);与单采前相比,单采后患者中性粒细胞与淋巴细胞比值(NLR)和CD4^(+)/CD8^(+)均无显著改变(P>0.05)。结论:单采自体红细胞会引起WBC参数的变化,建议单采前对WBC计数进行评估;单采前后中性粒细胞和T/B/NK淋巴细胞亚群在血液中的所占的百分率无明显变化,即单采过程没有打破患者免疫细胞间原有的平衡。

Objective:To explore the effects of apheresis autologous red blood cells(RBCs)on peripheral blood white blood cells(WBC)count,classification and T/B/NK lymphocyte subsets levels in patients undergoing elective surgery.Methods:Blood cell analyzer and flow cytometry were used to detect peripheral blood WBC parameters and T/B/NK lymphocyte subsets before and af-ter apheresis autologous RBCs in 26 patients undergoing elective surgery.Results:Compared with before apheresis,the count of WBC,neutrophils(NEUTs)and lymphocytes(LYMs)decreased after apheresis autologous RBCs(P<0.01).The value of 24 cases of WBC decline was in the normal range,and 2 cases were below the lower limit of normal value;there was no correlation between the change of WBC multiple(WBC count before apheresis autologous RBCs/WBC count after apheresis autologous RBCs)and BMI,blood volume,WBC count before apheresis autologous RBCs(r=−0.1130,P=0.5826;r=0.1187,P=0.6033;r=0.0065,P=0.9747);there was no significant change in the percentage of NEUTs,LYMs,T cells,CD4^(+)T cells,CD8^(+)T cells,B cells and NK cells before and after apheresis autologous RBCs(P>0.05);there was no significant change in the ratio of neutrophils to lymphocytes(NLR),CD4^(+)/CD8^(+)before and after apheresis autologous RBCs(P>0.05).Conclusion:Apheresis autologous RBCs can cause changes in WBC parameters.It is recommended that WBC count be evaluated before apheresis autologous RBCs;there was no significant change in the percentage of NEUTs and T/B/NK lymphocytes subsets in the blood before and after apheresis autologous RBCs.That is,the apheresis autologous RBCs process does not break the original balance between the immune cells.