异体或自体输血对肿瘤患者围手术期T淋巴细胞亚群、NK细胞影响的比较研究

Comparative effect of homologous versus autologous blood transfusion on T-lymphocyte subsets and natural killer cell during perioperative period in cancer patients

目的 :探讨异体输血和急性等容量血液稀释自体输血对肿瘤患者围手术期T淋巴细胞亚群、NK细胞的影响。方法 :食道癌及胃癌根治术患者 10 0例 ,随即等分为 2组 ,异体输血组 (Ⅰ组 )术中输异体全血 4 0 0ml,自体输血组 (Ⅱ组 )入手术室放血 4 0 0ml,同时输入等量贺斯 ,术中自体血回输给患者。分别于入手术室、术后第 1天及第 5天抽取静脉血 ,测定T细胞亚群和NK细胞的数量。结果 :两组术后第 1天CD3+ 、CD4 + 、CD4 + /CD8+ 、NK细胞较术前显著减少 (P <0 0 5或P <0 0 1) ,异体输血组较自体输血组减少更明显 (P <0 0 5 )。术后第 5天异体输血组CD3+ 、CD4 + 、CD4 + /CD8+ 、NK细胞仍较术前显著减少 ,自体输血组基本恢复正常。结论 :围术期异体输血患者免疫功能的抑制较急性等容量血液稀释自体输血者严重 ,自体输血对免疫抑制轻 。

Objective:To investigate the changes in T Lymphocyte subset and natural killer cell on cancer patients during perioperative period after homologous and autologous blood transfusion Methods: 100 patiens undergoing radical esophagus and stomach cancer surgery were radomly divided into 2 groups GroupsⅠreceive 400ml homologous blood transfusion and Group Ⅱ receive 400ml autologous blood transfusion Venous blood samples were taken before surgery, on 1st and 5th postoperative for determination of T Lymphocyte subsets and natural killer cell counts by flow cytometry Results:The number of CD3 + ?CD4 + ?CD4 + /CD8 + ,NK cell was decreased obviously on 1st postoperative compare with preoperation( P <0 05 or P <0 01) Group Ⅰdecreased more obviously than GroupⅡ( P <0 05) The same existed in 5th postoperative in Group Ⅰ, but the number of CD3 + ?CD4 + ?CD4 + /CD8 + NK cell recover in GroupⅡ Couclusions: The homologous tranfusion can bring more serious inhibitory effection than autologous transfusion can do during peroperative period The patients of autologous transfusion have only a slim inhibitory and a rapid recover