围术期异体或自体输血对骨科手术患者免疫功能的影响  

Effect of Perioperative Allogeneic or Autologous Transfusion on Immune Function During Orthopedic Operation

作　　者：邱颐[1] 龚玉华[2] 

机构地区：[1]内蒙古医学院第二附属医院麻醉科,内蒙古呼和浩特010030 [2]内蒙古医学院附属医院麻醉科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2006年第3期206-208,共3页Inner Mongolia Medical Journal

摘　　要：目的:探讨骨科手术异体与自体血回输对患者血清炎症性细胞因子白介素-1β(IL-1β)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及免疫球蛋白IgA、IgG、IgM的影响。方法:40名骨科手术患者,随机分为两组:自体血回输组20名;异体输血组20名。两组均于麻醉前、术后1d、术后7d采外周静脉血5ml,离心后取血清2ml于低温冰柜保存待检。结果:术后1d IgA、IgG两组均降低,IL-6、IL-8、TNF-α两组均升高,但两组差异有显著性,P<0.05;术后7d与术前相比,两组差异有显著性,P<0.05;IL-1β、IgM两组变化不显著,差异无显著性,P>0.05。结论:炎症性细胞因子IL-6、IL-8、TNF-α及免疫球蛋白IgA、IgG在自体输血、异体输血后变化有显著差异。自体输血对患者免疫功能影响较小,异体输血抑制了患者术后抗感染及伤口愈合等能力,对免疫功能抑制明显。Objective：To investigate the effect of allogeneic or autologous transfusion on serum interleukin- 1β（IL- 1β）, interleukin- 6 （IL- 6）, interleukin - 8 （IL- 8）, tumor necrosis factor-α （TNF-α） and immunoglobulin A, G, M （IgA, IgG, IgM） in orthopedic patients undergoing general anesthesia. Methods： 40 patients undergoing orthopedic operation were randomly divided into two groups：group Ⅰ with autologous transfusion （ n = 20） and group Ⅱ with allogeneic transfusion （ n = 20）. The levels of serum IL - 1β, IL - 6, IL - 8, TNF -α and IgA, IgG, IgM were measured before anesthesia,on the 1 day and 7 day after operation. Results：On the 1 day after operation, the levels of IgA and IgG decreased and those of IL - 6, IL- 8 and TNFα increased in both groups,but the difference between two groups was significant （P 〈 0.05）. There was significant difference between two groups on postoperative 7 day and before operation （P〈0. 05）. The levels of IL- 1β and IgM did not change markedly between two groups, showing no significant difference （ P 〉 0.05）. Conclusion： The levels of IL- 6, IL- 8, TNF-α and IgA, IgG change markedly after autologous or allogeneic transfusion. Autologous transfusion has less influence upon immune function. Allogeneic transfusion suppresses the function of anti- infection and wound healing in postoperative patients, thereby inhibits the patient＇s immune function.

关 键 词：自体输血 异体输血 炎症性细胞因子 免疫球蛋白 免疫功能 

分 类 号：R687.3[医药卫生—骨科学] R057[医药卫生—外科学]