贮存式异体成分输血对脊柱手术患者Th1/Th2、Th17/Treg细胞因子失衡的影响

Effect of stored allogeneic component transfusion on Th1/Th2 and Th17/Treg cytokine imbalance in patients undergoing spinal surgery

目的 分析研究贮存式异体成分输血对脊柱手术患者Th1/Th2、Th17/Treg细胞因子失衡的影响。方法 选取2020年1月至2022年12月在西安市中心医院116例进行脊柱手术治疗的患者作为研究对象,采用随机数字表法分为观察组(n=58)与对照组(n=58),其中观察组进行贮存式异体去白细胞的红细胞悬液成分血输注,对照组进行贮存式异体普通悬液加血浆输注。比较两组输血前与输血3 d后外周血的Th1、Th2、Th17、Treg、Th1/Th2、Th17/Treg及Th1类细胞因子(IL-2、TNF-α、IFN-γ)、Th2类细胞因子(IL-4、IL-6、IL-10)、Th17类细胞因子(IL-17)与Treg类细胞因子(TGF-β)水平;比较两组输血后不良事件发生率。结果 两组输血3 d后外周血的Th1、Treg与Th1/Th2水平均高于输血前,Th2、Th17与Th17/Treg均低于输血前(t=14.564、8.139;13.940、8.592;8.648、4.343;4.366、10.322;13.434、7.469;10.973、6.291;11.979、7.512;10.214、17.777,均P<0.05);观察组输血3 d后外周血的Th1、Th17、Th1/Th2与Th17/Treg水平均高于对照组,Th2与Treg水平均低于对照组(t=2.477、2.685、8.104、5.989、4.314、3.707,均P<0.05);两组输血3 d后外周血的IL-2、TNF-α、IFN-γ与TGF-β水平均高于输血前,IL-4、IL-6、IL-10与IL-17水平低于输血前(t=14.564、8.139;13.940、8.592;8.648、4.343;4.366、10.322;13.434、7.469;10973、6.291;11.979、7.512;10.214、17.777,均P<0.05);观察组输血3 d后外周血的IL-2、TNF-α、IFN-γ与IL-17水平均高于对照组,IL-4、IL-6、IL-10与TGF-β水平均低于对照组(t=6.251、5.361、4.840、7.421、6.156、5.712、5.628、5.327,均P<0.05);观察组输血后不良事件发生率低于对照组(χ^(2)=4.245,P<0.05)。结论 贮存式异体成分输血对脊柱手术患者Th1/Th2、Th17/Treg细胞因子失衡具有影响,可能与贮存式异体输血中的白细胞成分有关。

Objective To analyze the effect of stored allogeneic component transfusion on Th1/Th2 and Th17/Treg cytokine imbalance in patients undergoing spinal surgery.Methods A total of 116 patients who underwent spinal surgery in Xian Central Hospital from January 2020 to December 2022 were selected as the research objects.They were divided into the observation group(n=58)and the control group(n=58)by random number table method.The observation group was transfused with stored allogeneic leucocyte components,and the control group was transfused with stored allogeneic ordinary suspension plus plasma.The levels of Th1,Th2,Th17,Treg,Th1/Th2,Th17/Treg and Th1 cytokines(IL-2,TNF-α,IFN-γ),Th2 cytokines(IL-4,IL-6,IL-10)and Th17 cytokines(IL-1)in peripheral blood between the two groups were compared before and after 3 d transfusion 7).The levels of Treg-like cytokines(TGF-β),the incidence of adverse events after transfusion was compared between the two groups.Results The levels of Th1,Treg and Th1/Th2 in the peripheral blood of both groups after 3 days of transfusion were higher than before transfusion,while Th2,Th17 and Th17/Treg were lower than before transfusion(t=14.564,8.139;13.940,8.592;8.648,4.343;4.366,10.322;13.434,7.469;10.973,6.291;11.979,7.512;10.214,17.777,P<0.05).The levels of Th1,Th17,Th1/Th2 and Th17/Treg in peripheral blood in the observation group were higher than those in the control group,while the levels of Th2 and Treg were lower than those in the control group(t=2.477,2.685,8.104,5.989,4.314,3.707,P<0.05).The levels of IL-2,TNF-α,IFN-γand TGF-βin peripheral blood of the two groups were higher than before transfusion,and the levels of IL-4,IL-6,IL-10 and IL-17 were lower than before transfusion(t=14.564,8.139;13.940,8.592;8.648,4.343;4.366,10.322;13.434,7.469;10973,6.291;11.979,7.512;10.214,17.777,P<0.05).After 3 days of blood transfusion,the levels of IL-2,TNF-α,IFN-γand IL-17 in peripheral blood in the observation group were higher than those in the control group,while the levels of IL-4,IL-6,IL-10 and TGF-βwere lower than those in the control group(t=6.251,5.361,4.840,7.421,6.156,5.712,5.628,5.327,P<0.05).The incidence of adverse events in the observation group was lower than that in the control group(X^(2)=4.245,P<0.05).Conclusion The Th1/Th2 and Th17/Treg cytokines imbalance in spinal surgery patients can be affected by stored allogeneic transfusion,which may be related to the leukocyte components in stored allogeneic transfusion.