滤除白细胞异体血对围术期患儿细胞免疫功能的影响  

Effects of leukocyte-depleted allogeneic blood transfusion on perioperative cellular immunity in children

作　　者：邢准[1] 王秋实[1] 刁艳妮[1] 杨巧妮[1] 段小晶[1] 吴思梦[1] 孟凌新[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳市110004

出　　处：《中华麻醉学杂志》2011年第7期816-818,共3页Chinese Journal of Anesthesiology

基　　金：辽宁省教育厅课题（20060975）

摘　　要：目的评价滤除白细胞异体血对围术期患儿细胞免疫功能的影响。方法选择术中行异体输血的患儿359例，年龄3个月～14岁，体重5～74kg，ASA分级I或Ⅱ级，采用随机数字表法，将其随机分为2组：对照组（C组，n=163）术中输注未滤除白细胞的异体血；滤除白细胞异体血组（D组，n=196）术中输注滤除白细胞的异体血。分别于输血前、输血后2和6d时，采外周静脉血样，采用流式细胞仪测定CD3＋、CD4＋、CD8＋、CD56＋的水平，计算CD4＋／CD8＋。记录术中输血量、手术时间、术后引流时间、抗生素使用时间、住院时间和术后感染的发生情况。结果与C组比较，D组输血后6d时CD3＋、CD4＋、CIM＋／CD8＋和CD56＋的水平升高，引流时间、抗生素使用时间和住院时间缩短，术后感染发生率降低（P〈0．05）。两组CD8＋水平、术中输血量和手术时间差异无统计学意义（P〉0．05）。结论输注滤除白细胞的异体血有助于改善围术期患儿的细胞免疫功能。Objective To investigate the effects of leukocyte-depleted allogeneic blood transfusion on perioperative cellular immunity in children. Methods Three hundred and fifty-nine ASA Ⅰ or Ⅱ children aged 3 month-14 yr, weighing 5-74 kg requiring allogeneic blood transfusion during operation were randomly divided into 2 groups： control group （group C, n = 163） and leukocyte depletion group （group D, n = 196）. In group D alloge- neic blood was filtered with a leukocyte filter before being transfused during operation. Blood samples were collected from peripheral vein before blood transfusion, and at 2 and 6 d after blood transfusion for determination of levels of CD3＋ , CIM＋ , CD8＋ , and CD56＋ by flow cytometry. CIM＋/CD8＋ ratio was calculated. The volume of allogeneic blood transfused during operation, the duration of operation, postoperative drainage, antibiotics administra- tion and hospital stay and incidence of postoperative infection were recorded. Results The levels of CD3＋ , CD4＋ , CD56＋ and CD4＋/CD8＋ ratio were significantly increased at 6 d after blood transfusion while the duration of postoperative drainage, postoperative antibiotics administration and hospital stay and incidence of postoperative infection were significantly decreased in group D compared with group C. Conclusion Leukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.

关 键 词：白细胞去除术 输血 免疫 细胞 儿童 

分 类 号：R457[医药卫生—治疗学]