法乐氏四联症心内直视手术对血清免疫球蛋白水平的影响  

Serum immunoglobulin levels in patients with Fallot's tetrad before, during and after open heart surgery

作　　者：刘苏燕[1] 刘学成[1] 李恩善[2] 

机构地区：[1]沈阳军区总医院检验科 [2]第四军医大学免疫学教研室

出　　处：《第四军医大学学报》1991年第1期43-44,共2页Journal of the Fourth Military Medical University

摘　　要：作者报道了27例法乐氏四联症患者体外循环心内直视手术过程中的血清3种免疫球蛋白水平的变化转流前、中及转流后4h,IgG的水平分别为14.60±3.90,10.50±270和5.40±3.10g/L,IgA的水平分别为1.29±0.48,0.89±0.25和0.43±0.22g/L;IgM的水平分别为1.44±057,0.98±0.48和0.46±0.24g/L.转流中与转流后4h,免疫球蛋白水平呈急骤持续下降的趋势,与转流前相比有非常显著的差异(P<0.01).体外循环中灌注液使血液大量稀释(转流前、中、后血球比积分别为0.71,0.22和0.46)和非生理性装置对血液免疫球蛋白的机械性破坏,均可导致单位体积血液中免疫球蛋白水平的下降.因此术后1周内预防感染十分重要.The changes of scrum immunoglobulin (Ig) levels in 27 patients with Fallot's tetrad (FT) during open heart surgery were reported Before, during and 4 hours after the bypass circuit, the levels of blood IgG were 14.60± 3.90, 10.50 ± 2.70, and 5.40 ± 3.40 g/L; IgA 1.29 ± 0.48, 0.89 ± 0.25 and 0.43 ± 0.22 g/L; IgM 1.44 ± 0.57, (198 ± 0.48 and 0.46 ± 0.24 g/L, respectively. It was found that scrum Ig levels declined sharply and gradually and significantly during and 4 hours after the bypass circuil (P<0.01). Moreover, blood was highly diluted due to perfusion during bypass circuit since the hematocrit was 0.71, 0.22 and 0.46 respectively, before, during and after bypass circuit,and blood Ig was damaged due to non-physiological apparatus used in bypass circuil, which may account for the decline of blood Ig levels per unit volume. Thus it is important to prevent infection in the first week after operation.

关 键 词：法乐氏四联症 免疫球蛋白 体外循环 

分 类 号：R446.62[医药卫生—诊断学]