围术期异体红细胞输注对胃癌患者T细胞亚群的影响  

Effect of perioperative allogeneic blood transfusion on T-Lymphocyte subsets in patients with gastric cancer

作　　者：洪金全[1] 陈志远[1] 张进萍[2] 刘炜峰 翁培清[1] 何荷番[1] 

机构地区：[1]福建医科大学附属第二医院麻醉科,福建泉州362000 [2]厦门大学附属福州第二医院输血科,福建福州350000

出　　处：《中国输血杂志》2014年第12期1299-1302,共4页Chinese Journal of Blood Transfusion

基　　金：福建省自然科学基金(编号:2012J01427);福建省卫生厅青年科学基金(编号:2012-2-53);泉州市科技局建议资助项目(编号:2013-15)

摘　　要：目的探讨围术期异体红细胞输注对胃癌患者细胞免疫的影响。方法回顾性分析2012年6月-2013年6月手术治疗的39名胃癌患者围术期异体红细胞输注情况及其T细胞亚群检测结果,并根据异体红细胞输注情况分为输血组18名(Hb<100 g/L、输血量2-6 U)、未输血组21名(Hb>100g/L)。结果术前2组患者一般情况及外周血CD3+、CD4+、CD8+细胞比例和CD4+细胞/CD8+细胞比值具有可比性(P>0.05)。术后d5,2组患者的外周血CD3+、CD4+细胞比例和CD4/CD8比值均较术前明显降低(P<0.05),仅CD8+细胞比例差异不明显(P>0.05);输血组与未输血组患者外周血CD3+细胞比例(%)为53.32±2.61 vs 62.10±2.47、CD4+细胞比例(%)为27.91±1.58 vs 37.91±1.60、CD4+/CD8+细胞比值为1.41±0.15 vs 1.81±0.17(均为P<0.05)。输血组中,异体红细胞输注量≥4 U与<4 U的患者术后d5外周血CD3+细胞比例(%)为47.16±3.55 vs 59.67±2.52、CD4+细胞比例(%)为24.99±2.60 vs 33.85±2.43、CD4+/CD8+比值为1.20±0.18 vs 2.26±0.24(均为P<0.05);输血组中异体红细胞输注量<4 U的患者与未输血组患者的外周血CD3+、CD4+、CD8+细胞比例和CD4+/CD8比值均无明显差异(P>0.05)。结论围术期异体红细胞输注量可以影响胃癌手术患者细胞免疫功能。Objective To explore the effect of perioperative allogeneic blood transfusion on cell immunity in patients with gastric cancer. Methods The data on perioperative allogeneie blood transfusion and the results of T lymphocyte subsets of thirty-nine patients who underwent gastric cancer operation and were hospitalized from June 2012 to June 2013 were retro- spectively analyzed. Patients with or without perioperative allogeneic blood transfusion were divided into two groups： a transfu- sion group which included 18 patients whose hemoglobin 〈 100 g/L and transfusion volume ranged from 2 to 6 units artd a non-transfusion group which included 21 patients whose hemoglobin 〉 100 g/L. Results There were not significant differ- ences between two groups under general condition in the percentage of CD3 ＋ cell, CD＋ cell, CD8 ＋ cell, CD4 cell/CD8＋ cell ratio before operation （P 〉 0. 05 ）. Compared with pre-operation, percentage of CD3＋ cell, CD＋ cell and CD4＋ cell/ CD8 ＋ cell ratio in transfusion group decreased significantly five days after operation （ P 〈 0. 05 ）. However, there was not sig- nificant difference in the percentage of CD8 ＋cell five days after operation compared with that in pre-operation （ P 〉 0.05 ）. Between the transfusion group and non-transfusion group, the percentage of CD3 ＋ cell was 53. 32 ± 2. 61 vs 62. 10 ± 2. 47, the percentage of CD4 ＊ cell was 27.91±1.58 vs 37. 91± 1.60, and the CD4＋ceU/CD8 ＋ cell ratio was 1.41±0. 15 vs 1.81 ＋0. 17 （all of them, P〈0. 05）. In the transfusion group, between patients with transfusion volume ≥4 U and 〈4 U, the percentage of CD3 ＋ cell was 47. 16 ± 3.55 vs 59. 67 ± 2.52, the percentage of CD4＋ cell was 24. 99 ± 2. 60 vs 33.85 ± 2.43, and the CD4＋ ceII/CD8 ＋ cell ratio was 1.20 ± 0. 18 vs 2. 26 ± 0. 24 （ all of them, P 〈 0. 05）, five days after operation. There were not significant difference in the percentage of CD3＋ cell, CD4 ＋ cell and CD4 ＋ ceU/CD8＋ cell ratio between pa- ti

关 键 词：输血 同种异体红细胞 手术患者 胃癌 T亚群细胞 免疫 

分 类 号：R457.1[医药卫生—治疗学] R735.2[医药卫生—临床医学]