心脏瓣膜置换术后机体免疫功能的变化  

Changes of immunological function after cardiopulmonary bypass on patients with rheumatic heart valve disease

作　　者：郭宏伟[1] 于建华[2] 刘美明[3] 吴树明[2] 张供[2] 廖崇先[1] 

机构地区：[1]厦门大学附属中山医院,福建厦门361004 [2]山东大学齐鲁医院 [3]山东省胸科医院

出　　处：《山东医药》2009年第18期15-17,共3页Shandong Medical Journal

基　　金：2002年山东省中青年优秀科学家奖励基金资助项目(9834)

摘　　要：目的探讨体外循环心脏瓣膜置换术后机体免疫功能的变化。方法28例风湿性心脏瓣膜病患者,分别于术前第3天、体外循环结束后10 min、术后第1天、术后第3天及术后第7天5个时点取外周静脉血。流式细胞术测定CD3+、CD4+、CD8+,计算CD4+/CD8+,采用免疫化学分析系统测定血清IgG、IgA、IgM浓度。结果体外循环后CD3+、CD4+、CD8+及CD4+/CD8+均较术前下降(P<0.05),血清IgG、IgA、IgM浓度也明显低于术前水平(P均<0.05),术后第7天均恢复正常。结论体外循环能导致机体细胞免疫及体液免疫功能下降,至术后第7天基本恢复。Objective To study the Change of immunological function after cardiopulmonary bypass on patients with rheumatic heart valve disease. Methods Twenty eight patients with rheumatic heart valve disease were studied. For each patient, peripheral blood samples were taken three days before operation, ten minutes after the termination of CPB, on the first, third , and seventh day after operation respectively. The percentage of T lymphocyte （TC） subsets including CD3＋, CD4＋ and CD8＋ as well as CD4＋/CD8＋ were examined with flow cytometry. Serum levels of immunoglobulin IgG, IgA and IgM were measured. Results It was found that the percentage of CD3＋ , CD＋ and CD8＋ as well as CD4＋/CD8＋ reduced af- ter eardiopulmonary bypass. Levels of immunoglobulin IgG, IgA and IgM reduced at this test. However, almost all of the above returned to their preoperational level within seven days after operation. Conclusion Both the cellular and the somatic immune function could be suppressed by cardiopulmonary bypass. However, they recover within seven days after operation without intervention.

关 键 词：心脏瓣膜置换术 体外循环 T细胞亚群 免疫球蛋白 

分 类 号：R654.2[医药卫生—外科学]