血液回收和血液保存对成人红细胞免疫功能的影响  

Effects of blood salvage and preservation on erythrocyte unmunity in adults

作　　者：赵砚丽[1] 王丽华[1] 赵鹤龄[1] 张凤霞[1] 曲振华[2] 

机构地区：[1]河北省人民医院麻醉科,石家庄市050051 [2]邢台市人民医院麻醉科

出　　处：《中华麻醉学杂志》2005年第7期540-542,共3页Chinese Journal of Anesthesiology

基　　金：河北省自然科学基金资助项目(302611)

摘　　要：目的探讨血液回收和血液保存对成人红细胞免疫功能的影响。方法选择进行血液回收的手术患者50例,患者术中回收的红细胞为Ⅰ组;Ⅰ组患者的术野红细胞50份为Ⅱ组;库存2周的浓缩红细胞50份为Ⅲ组。分别测定三组红细胞的受体花环形成率、免疫复合物花环形成率、CD35 阳性红细胞百分率及超氧化物歧化酶水平。结果Ⅰ组与Ⅲ组红细胞受体花环形成率、CD35阳性红细胞的百分率及红细胞超氧化物歧化酶水平均低于Ⅱ组,且Ⅰ组上述指标均高于Ⅲ组(P<0.05或0.01)。三组红细胞免疫复合物花环形成率比较差异无统计学意义(P>0.05)。结论血液回收可在一定程度上损害红细胞的免疫功能,但术中回收红细胞的免疫功能优于库存2周的红细胞。Objective To examine the effects of blood salvage and blood preservation on erythroeyte immunity in adults. Methods Fifty patients of both sexes （22 males, 28 females） aged 25-69 yr undergoing cardiovascular or orthopedic surgery, or surgery, for spleen rupture or ruptured eetopie pregnancy during which ZITI- 2000 autotransfusion system was used to salvage shed blood were enrolled in this study. Blood samples were taken from autotransfusion system after being heparinized, filtered, centrifuged and washed （n = 50） （group Ⅰ ）, and also directly from operative field （n = 50） （group Ⅰ] ）. In group Ⅲ blood samples were taken from bank blood after being preserved in citrate-phosphate-dextrose-adenine （CPDA） anticoagulant solution for 2 weeks （n = 50） . The rosette rate of RBC-C3b receptor （RBC-C3b RR）, The rosette rate of RBC-immune complex （RBC-ICR）, the percentage of CD35-positive erythmcyte and the content of SOD in erythrocyte were measured. Results The RBC- C3b RR, the percentage of CD35-positive erythrocyte and the SOD content in erythrocyte were significantly lower in group Ⅰ and Ⅲ than in group Ⅱ （ P 〈 0.05 or 0.01 ） and were significantly higher in group Ⅰ than in group Ⅲ （ P 〈 0.05 or 0.01 ）. There was no significant difference in RBC-ICR among the 3 groups. Conclusion Blood salvage causes injury, to erythmcyte immunity to some extent. The salvaged blood is still significantly better than the bank blood which has been preserved for 2 weeks in terms of erythrocyte immunity.

关 键 词：血液回收 血液保存 成年 红细胞 免疫功能 

分 类 号：R457[医药卫生—治疗学] R392[医药卫生—临床医学]