围手术期自体输血对恶性肿瘤患者血清白介素-2、前列腺素2水平影响

Effect of perioperative autologous blood transfusion on serum IL-2 and PGE2 in patients with malignant tumor

目的为指导肿瘤患者围手术期合理输血,探讨围手术期自体输血对恶性肿瘤住院患者血清白介素-2(IL-2)和血清前列腺素E2(PGE2)水平的影响。方法选取2015年1月—2016年1月河南省人民医院收治的96例恶性肿瘤患者,随机分为观察组和对照组,每组48例。观察组在住院期间输注去白细胞血液,包括红细胞、血浆、血小板和冷沉淀;对照组不接受输血。采用酶联免疫法测定并比较两组患者治疗前后IL-2和PGE2水平;观察并比较两组患者术后肿瘤转移复发率及输血期间不良反应发生情况。结果术前第1天,两组患者IL-2和PGE2水平比较,差异无统计学意义(P>0.05);术后第1、7天,两组与本组术前第1天比较,均明显提高,差异有统计学意义(P<0.05);两组间比较差异无统计学意义(P>0.05)。术后3个月,观察组的患者肿瘤转移复发率(6.25%)明显低于对照组(22.92%),存活率(89.58%)高于对照组(72.92%),差异有统计学意义(P<0.05)。结论自体输血对胃肠道恶性肿瘤患者免疫功能抑制不明显,术后并发症少,延长了患者生存期。

Objective To investigate the effect of perioperative blood transfusion on serum IL-2 and PGE2 levels in hospitalized patients with malignant tumor for guiding how to reasonably transfuse blood in perioperative period. Methods Totally forty-nine patients with malignant tumors treated in Henan Province People's Hospital from January 2015 to January 2016 were enrolled and randomly divided into observation group and control group(n=48). The observation group received blood without white cells transfusion during hospitalization, including red blood cells, plasma, platelets and cold precipitates; the control group did not receive blood transfusion. The levels of IL-2 and PGE2 in the two groups were measured by enzyme-linked immunosorbent assay before and after treatment. The recurrence rate of tumor metastasis and the occurrence of adverse reactions during transfusion were observed and compared between the two groups. Results There were no significant difference in IL-2 and PGE2 levels between the two groups on the first day before operation(all P>0.05). Compared with the first day before operation, IL-2 and PGE2 levels in the two groups were all significantly higher on the first day and the seventh day after operation(all P<0.05), but there were not statistically different in the two groups(all P>0.05). At 3 months after operation, the recurrence rate of tumor metastasis in the observation group was significantly lower than that in the control group(6.25% vs.22.92%). The survival rate in the observation group and control group was 89.58%, 72.92%, respectively, and the difference was statistically significant(P<0.05). Conclusion Autologous transfusion has no obvious effect on immune function, can make complication after operation decrease and extend the survival time in patients with malignant tumor of gastrointestinal tract.