库存悬浮红细胞洗涤处理对婴幼儿体外循环后炎症因子水平的影响  

Influence of washing suspended red blood cells on the levels of inflammatory factors after cardiopulmonary bypass in infants

作　　者：杨玉齐[1] 徐红亮[1] 范顺阳[1] 石磊[1] 尉新华[1] 张金涛[1] 徐云飞[1] 李群[1] 

机构地区：[1]郑州大学第三附属医院心脏中心河南省先心病诊疗中心,河南郑州450052

出　　处：《中国输血杂志》2015年第10期1225-1228,共4页Chinese Journal of Blood Transfusion

摘　　要：目的观察库存悬浮红细胞应用血液回收机洗涤处理后预充对婴幼儿体外循环后炎症因子水平的影响。方法选取室间隔缺损择期手术患儿40名,随机分成对照组A(Group A)实验组B(Group B),A组对CPB预充用库存悬浮红细胞不进行任何处理,B组应用血液回收机对库存悬浮红细胞进行洗涤处理后再预充。分别在体外循环开始前(T1)、体外循环结束时(T2)、术后2 h(T3)、术后12 h(T4)、术后24 h(T5)取动脉血标本行TNF-α、IL-6、IL-8、IL-10和C-反应蛋白(CRP)检测,比较2组之间差异。结果 2组患儿的血TNF-α、IL-6、IL-8、IL-10和CRP在T2、T3、T4均呈持续升高趋势并在T5恢复至略高于术前水平;TNF-α、IL-8在术后整个过程实验组均显著低于对照组(P<0.05);IL-6、IL-10在T5实验组和对照组差别无统计学意义(P>0.05);CRP T3至T5显著升高无下降趋势且实验组显著低于对照组(P<0.05)结论血液回收机洗涤预充用库存悬浮红细胞可降低婴幼儿体外循环后机体炎症因子水平,减轻全身炎症反应,促进患儿术后恢复。Objective To observe the influence of washing suspended red blood cells （RBCs） with cell salvage on the levels of inflammatory factor after cardiopulmonary bypass （ CPB ） in infants. Methods 40 infants with ventricular septal defects （VSD） were randomly divided into control group （ A, n = 20） and experimental group （ B, n = 20）. Suspended RBCs were washed with cell salvage before priming in group B. In group A, the RBCs were primed directly without any treat- ment. Samples of the arterial blood were obtained respectively before the start of CPB （ T1 ）, when the CPB stop （ T2）, 6h after CPB （T3） ,12h after CPB （T4） and 24h after CPB （TS）. The levels of TNF-α, IL-6, IL-8, IL-10 and CRP were de- tected and the differences between the two groups were comparatively analyzed. Results The levels of TNF-α, IL-6, IL-8, IL-10 and ClIP in two groups at T2, T3, T4 showed an obvious rising trend in both two groups, but the levels of TNF-ot and IL-8 in group B were significantly lower than those in group A at T2, T3, T4 and T5 （ P 〈 0.05 ）. There were no significant differences at the levels of IL-6 and IL-10 in two groups at T5. The sensitivity of the CRP was relatively lagging and at T3, T4, T5 and was significant lower in group B than in group A （ P 〈 0. 05）. Conclusion The washing processing of suspended RBCs with cell salvage can reduce the levels of inflammatory factor after CPB in infants and relieve systemic inflammatory response.

关 键 词：悬浮红细胞 血液回收机 婴幼儿 体外循环 炎症因子 

分 类 号：R654.1[医药卫生—外科学] R457.13[医药卫生—临床医学]