川芎嗪对自体血回输患者围术期体液免疫功能的影响  

Effect of tertamethylpyrazine on perioperative humoral immune function in patients required for autologous blood transfusion

作　　者：张子银[1] 马武华[1] 蔡诚毅[1] 

机构地区：[1]广州中医药大学第一附属医院麻醉科,510405

出　　处：《中华麻醉学杂志》2012年第2期161-163,共3页Chinese Journal of Anesthesiology

基　　金：广东省科学技术厅社会发展计划项目（20098030801303）;广东省中医药局建设中医药强省科研课题基金（2009397）;2008年度贝朗麻醉科学研究基金

摘　　要：目的探讨川芎嗪对自体血回输患者围术期体液免疫功能的影响。方法择期行脊柱手术患者60例，年龄20．60岁，体重50～75kg，ASA分级Ⅰ或Ⅱ级，采用随机数字表法，将患者随机分成2组（n=30），试验组：于收集自体血前30min，经5min静脉输注川芎嗪2mg／kg，并在回收血液的肝素盐水和洗涤盐水内加入川芎嗪，每500ml加入川芎嗪25mg；对照组不给予川芎嗪。于麻醉诱导前（T0）、术后1h（T1）、1d（B）及5d（T3）时取静脉血样，采用ELISA法测定血清免疫球蛋白（IgG、IgM）的浓度；记录手术时间、术中出血量、回输血量。结果两组患者手术时间、术中出血量、回输血量比较差异无统计学意义（P〉0．05）。与T0时比较，对照组，T1～T3时血清IgG和IgM浓度降低，试验组T1、T2时血清IgG浓度降低（P〈0．05或0．01），T3时差异无统计学意义，T1～T3时血清IgM浓度差异无统计学意义（P〉0．05）；与对照组比较，试验组T2、L时血清IgG浓度、T1—T3时血清IgM浓度升高（P〈0．05或0．01）。结论川芎嗪可在一定程度上减轻自体血回输患者体液免疫抑制，改善体液免疫平衡状态。Objective To investigate the effect of tertamethylpyrazine on perioperative humoral immune function in patients required for autologous blood transfusion. Methods Sixty ASA I or II patients aged 20-60 yr weighing 50-75 kg undergoing elective spinal surgery were randomly divided into 2 groups （ n = 30 each） ： test group and control group. In test group, tertamethylpyrazine 2 mg/kg was infused intravenously over 5 rain at 30 min before the autologous blood was collected. Tertamethylpyrazine was added to the heparinized saline and washing sa- line at the same time （25 mg per 500 ml） until the final concentration reached 0.005% . Tertamethylpyrazine was not given in control group. Venous blood samples were taken before anesthesia induction （TO ） and at 1 h after op- eration （T~）, and on day 1 and 5 after operation （T2_3 ） for measurement of serum IgG and IgM concentrations by ELISA. The operation time, intraoperative blood loss and amount of salvaged blood reinfused were recorded. Re- suits There was no significant difference in the operation time, intraoperative blood loss and amount of salvaged blood reinfused between the two groups （P 〉 0.05）. Compared with the baseline value, at To , serum IgG and IgM concentrations were significantly decreased at T1-3 in control group and the serum IgG concentration was significantly decreased at T1,2 in test group （P 〈 0.05 or 0.01 ） . The serum IgG concentration at T2,3 and serum IgM concentra- tion at T1-3 were significantly higher in test group than in control group （ P 〈 0. 05 or 0.01 ）. Conclusion Tertam- ethylpyrazine can reduce humoral immunosuppression to some extent and improve the balance of humoral immunity in patients required for autologous blood transfusion.

关 键 词：川芎嗪 输血 自体 抗体生成 

分 类 号：R285.5[医药卫生—中药学]