经乌司他丁预处理的预存式自体血回输对围术期细胞免疫功能的影响  

作　　者：张明勋[1] 

机构地区：[1]山东省菏泽市立医院输血科,274000

出　　处：《浙江临床医学》2016年第10期1882-1883,共2页Zhejiang Clinical Medical Journal

摘　　要：目的：观察经乌司他丁预处理的预存式自体血回输对结直肠癌患者T细胞和NK细胞的影响。方法选择直肠癌、结肠癌ASAⅠ~Ⅱ级患者45例，随机分为预存式自体输血组（P组）、乌司他丁组（UC组）和联合治疗组（UN组），每组各15例。P组：患者于手术前3d采血400ml，在手术中出血时或在手术后回输。UN组：患者于术前7d时开始输注20万U乌司他丁1次/d，共4d，同时术前第3天采取静脉自体血400ml。UC组：患者乌司他丁的用药方式同联合治疗组，但于术前配悬浮红细胞2U（400ml），手术中止血完毕后或手术后输入；用流式细胞仪测定T淋巴细胞亚群CD3^＋、CD4^＋、CD8^＋、NK细胞胞（CD56＋）的数量，并计算CD4^＋/ CD＋8比值。结果麻醉前P组患者CD3^＋、CD4^＋、NK细胞数量及CD4^＋/CD8^＋的比值均低于UC组和UN组，而CD8^＋则高于UT组和UN组；术后1d UN组和UC仍高于P组，其中UN组低于UC组；术后3d各组数值开始恢复，UN组的CD3^＋、CD4^＋、CD4^＋/CD8^＋的比值以及NK细胞的数量与术前比较差异无统计学意义（P〉0.05），而其他两组则仍低于术前水平；术后5d三组患者的各项指标均恢复至术前水平，与术前比较差异无统计学意义（P〉0.05）。结论经乌司他丁预处理的预存式自体输血可通过改善肿瘤患者术前的细胞免疫抑制，改善术后患者的细胞免疫功能，促进患者早日康复。ObjectiveTo observe the UTI pretreated stored autologous blood transfusion in patients with colorectal cancer effects on T cells and NK cells.MethodsColorectal cancer,colon cancer ASAⅠ~Ⅱ grade 45 cases of patients were randomly divided into pre-existing autologous transfusion group（P group）,ulinastatin group（UC group）and combination therapy group（UN）group 15 example. Stored autologous blood groups：patients with 400ml of blood for three days before the surgery,when your hands are bleeding or transfusion after surgery. Combination therapy group：patients at the time of preoperative 7d starting daily 200,000 U Ulinastatin co-4d,and the third day to take intravenous preoperative autologous blood 400ml. UTI Group：Patients UTI medication the same way as the combined treatment group,but in the preoperative erythrocyte suspension with 2U（400 ml）,after the completion of surgery to stop bleeding after surgery or input;T lymphocytes was measured by flow cytometry. cell subsets CD3^＋,4^＋,8^＋,NK cells cells（CD56＋）by the number of CD CD,and calculate the CD4^＋ / CD8^＋ ratio.ResultsCD3^＋,CD4^＋,NK cells and the ratio of the number of patients in group P before anesthesia CD4^＋/CD8^＋were lower than the UC group and UN groups,and CD8^＋ were higher than UC group and UN group;postoperative 1d UN group and UC was still higher than P group,which UN group than UC group;3d after each set of values began to recover,CD3^＋ UN group,the difference was not statistically significant（P〉0.05 before CD4^＋,the ratio of CD4^＋ / CD8^＋ and the number of NK cells and surgery）,while the other two were still lower than the preoperative level;indicators were returned to preoperative levels 5d after three groups of patients,compared with the preoperative difference was not statistically significant（P〉0.05）.ConclusionsUTI pretreated stored autologous blood transfusions by improving cellular immunity in cancer patients before surgery inhibiting cell patients improve immune function,and

关 键 词：乌司他丁 预存式自体血 结直肠癌 细胞免疫 

分 类 号：R457.1[医药卫生—治疗学]