预存式自体输血对结直肠癌患者围术期细胞免疫功能的影响  

Effects of prestorage of autologous blood on cellular immunity in patients with colorectal cancer during the perioperative period

作　　者：屈常伟[1] 骆喜宝[1] 刘志贵[1] 陈燕[1] 卜文豪[1] 

机构地区：[1]桂林医学院附属医院麻醉科,541001

出　　处：《实用医学杂志》2013年第18期2986-2988,共3页The Journal of Practical Medicine

基　　金：广西卫生厅计划课题(编号:Z2012399)

摘　　要：目的:观察预存式自体输血对结直肠癌患者围术期细胞免疫功能的影响。方法:选择直肠癌、结肠癌ASAⅠ~Ⅱ级患者40例,随机分为预存式自体输血组(P组)和异体输血(H组),每组20例。P组患者于手术前1周采血400 mL;H组患者手术前配悬浮红细胞2 U(400 mL),两组均于手术中止血完毕后输入。两组病例均在麻醉诱导前、输血前、手术后第1天、手术后第5天分别抽取静脉血,以流式细胞仪测定T淋巴细胞亚群CD3^+、CD4^+、CD8^+和NK细胞数量的变化,并计算CD4^+/CD8^+比值。结果:两组输血前CD3^+、CD4^+、CD4^+/CD8^+和NK细胞数量均较麻醉前明显下降。术后1 d H组继续下降,P组开始恢复,但仍低于术前水平。术后第5天P组恢复至麻醉前水平,H组继续降低至明显低于正常水平,与麻醉前比较差异有统计学意义(P<0.05)。结论:预存式自体输血可以显著恢复结直肠癌患者围术期细胞免疫功能。Objective To observe the effects of prestorage of autologous blood on cellular immunity in patients with colorectal cancer during the perioperative period. Methods Forty ASA Ⅰ-Ⅱ paitents with colorectal cancer were involved in our study. All the patients were randomly divided into two groups： prestorage autologus blood transfusion group （group P, n = 20） and homologous transfusion group （group H, n = 20）. 400 mL blood was collected in group P one week before surgery, and then stored in a special refrigerator in the blood bank. 2 u （400 mL） red blood cell suspensions was matched for every patient in group H preoperatively. The blood was then infused after the completion of hemostasis. At the time of before anesthesia induction, one day before blood transfusion, and five days after surgery, the number of peripheral venous T lymphocyte subsets CD3＋, CD4＋, CD8＋, CD4＋/CD8＋ ratio and NK cells were measured by a flow cytometer. Results The number of CD3＋, CD4＋, CD4＋/CD8＋ and NK cells before blood transfusion significantly decreased than before anesthesia induction. One day after surgery, the indexes continued to decline in group H, while began to return to normal in group P. However, the indexes were still lower than the baselines （P 〈 0.05）. Five days after surgery, the indexes returned to the level before anesthesia induction in group P and continued to decrease in group H. Conclusions Prestorage of autologous blood can improve the function of cellular immunity in patients with colorectal cancer during the perioperative period.

关 键 词：结直肠肿瘤 预存式自体输血 细胞免疫 

分 类 号：R735.3[医药卫生—肿瘤]