FDP对体外循环病人红细胞免疫功能影响的临床研究临床研究  

A clinical study of fructose 1,6 diphosphate on erythrocyte immunity in patients during open heart surgery

作　　者：许学兵[1] 姚尚龙[2] 包光兴[2] 张诗海[2] 佘守章[1] 

机构地区：[1]广州市第一人民医院麻醉科,510180 [2]同济医科大学附属协和医院麻醉科

出　　处：《中华麻醉学杂志》1999年第4期224-226,共3页Chinese Journal of Anesthesiology

摘　　要：目的　研究１，６二磷酸果糖（ＦＤＰ）对体外循环（ＣＰＢ）手术病人围术期红细胞免疫粘附功能（ＲＣＩＡ）的影响。方法　２４ 例心内直视手术患者随机分为２ 组，生理盐水（ＮＳ）组和ＦＤＰ组各１２例，两组分别于麻醉前、ＣＰＢ前、停机后５ 分钟、术后２４ 小时、术后７２ 小时抽取静脉血检测红细胞Ｃ３ ｂ 受体花环形成率（ＲＢＣ·Ｃ３ｂＲ）及红细胞免疫复合物花环形成率（ＲＢＣ·ＩＣＲ）。结果　停机后及术后２４ 小时，ＮＳ组患者ＲＢＣ·Ｃ３ｂＲ 及ＲＢＣ·ＩＣＲ 均显著下降，ＲＢＣ·Ｃ３ｂＲ 下降率分别为２７６６％ ，３２１０％ （Ｐ＜ ００１）；ＲＢＣ·ＩＣＲ下降率分别为２３２８％ ，３２１６％ （Ｐ＜ ００１）；而ＦＤＰ组停机后及术后２４ 小时，ＲＢＣ·Ｃ３ｂＲ分别降低１６１５％ ，２０３９％ ，与术前相比降低明显（Ｐ＜ ００１）；但与ＮＳ组相比，其降低程度则有所减少（Ｐ＜ ００５）；ＲＢＣ·ＩＣＲ降低分别为１８２８％ ，２２８１％ ，与ＮＳ组相比无统计学差异；术后ＲＣＩＡ 功能恢复ＦＤＰ组较ＮＳ组亦有所提高。结论　ＦＤＰ（２００ｍObjective This study was to investigate the effects of fructose 1,6 diphosphate(FDP)on the red blood cell(RBC)immunoadherence (RCIA) during cardiopulmonary bypass(CPB).Methods Twenty four patients scheduled for cardiac surgery with CPB were randomly divided into two groups,normal saline(NS) group (n=12)and FDP group(n=12),200mg/kg FDP was given before anesthesia.The RCIA including erythrocyte C 3b receptor garland rate(RBC·C 3bR) and RBC immune complexes garland rate(RBC·ICR)were measured at specially designed time:pre anesthesia,pre CPB,5 min after weaning from CPB,24 and 72 hours postoperatively.All data of two groups were analyzed with t test.Results The RCIA was decreased gradually in both group,RBC·C 3bR and RBC·ICR at the time points of weaning from CPB and 24 hours postopratively were statistically different from pre anesthesia(P<0.01 or P<0.05).At all designed times except pre anesthesia the RCIA was higher in FDP group than that in NS group.At the time points of weaning from CPB and 24 hours postoperatively,the RBC·C 3bR in NS and FDP group were(13.52±2.14)%,(12.69±1.82)% and (15.46±2.26)%,(14.75±2.19)% respectively.The RCIA recovery of FDP group was also earlier than that of control group.Conclusion FDP has protective effects on the RCIA during CPB,which is beneficial to prevent postoperative infection

关 键 词：心肺转流术 红细胞免疫 体外循环 麻醉 FDP 

分 类 号：R654.1[医药卫生—外科学]