贮存式自体输血对择期手术患者血清IFN-γ、IL-10的影响  

Effect of Storage Autologous Blood Transfusion on Serum cytokines IFN-γ and IL-10 in Patients undergoing Elective Surgery

作　　者：张蕾[1] 杨宗树[2] ZHANG Lei;YANG Zong-shu(Blood Transfusion Department,Shihezi people’s Hospital,Xinjiang Shihezi,832000;Clinical Laboratory,the First Affiliated Hospital of Shihezi University School of Medicine,Xinjiang Shihezi,832008)

机构地区：[1]新疆石河子市人民医院输血科,新疆石河子832000 [2]石河子大学医学院第一附属医院检验科,新疆石河子832008

出　　处：《农垦医学》2019年第6期500-505,共6页Journal of Nongken Medicine

摘　　要：目的:通过研究择期手术患者术前、术后血清IFN-γ、IL-10的变化,了解贮存式自体输血对机体细胞免疫应答的影响。方法:随机数字法纳入2016年3月至2019年3月期间于石河子市人民医院住院并接受贮血式自体输血治疗的择期手术患者32例,作为观察组,相同方法纳入同期就诊的30例接受异体悬浮红细胞输入的择期手术患者作为对照组,分别在患者入院后、手术日(输血治疗)、术后24小时,术后7天经肘静脉采集空腹血,完善血常规、血生化指标检测,分离血清,使用商品化人IFN-γ、IL-10 ELISA检测试剂盒检测血清IFN-γ、IL-10浓度。结果:(1)手术前,两组患者血清IFN-γ、IL-10水平无差异(t=1.69,P=0.095;t=0.16,P=0.874);(2)术后24小时,两组患者血清IFN-γ、IL-10水平均显著升高,自体贮血输血组患者IFN-γ水平显著高于异体输血组(t=4.87,P<0.0001),IL-10水平显著低于异体输血组(t=17.95,P<0.0001);(3)术后7天,两组患者血清IFN-γ、IL-10水平均明显回落,但自体贮血输血组患者IFN-γ水平仍显著高于异体输血组(t=6.17,P<0.0001),同时其IL-10水平仍显著低于异体输血组(t=2.37,P=0.02)。结论:自体贮血输血治疗不影响输血者IFN-γ表达,异体输血组IL-10高表达与免疫抑制有关。Objective:To study the changes of serum IFN-γand IL-10 in patients undergoing elective surgery before and after operation,and to understand the effect of storage autologous blood transfusion on cellular immune response.Methods:A prospective case-control study was conducted.62 subjects who were enrolled in Shihezi people's Hospital from March 2016 to March 2019,32 patients were treated with storage autologous blood transfusion were named observation group,30 patients were treated with allogenic suspended red blood cell infusion were named control group.Fasting blood were collected through elbow vein at day of hospitalization,day of surgery(blood transfusion treatment),24 hours post surgery and 7 days post surgery,respectively,blood routine,clinical parameters such as liver functions,kidney functions,tumor marker and etc were measured by professional worker,residual serum was separated,serum IFN-γ,IL-10 concentration were detected by commercial human IFN-γ,IL-10 ELISA kit.Results:(1)There was no statistical difference in serum IFN-γand IL-10 levels between the two groups at prior surgery(t=1.69,P=0.095;t=0.16,P=0.874).(2)The concentration of serum IFN-γand IL-10 in both groups increased significantly at 24 hours post surgery,the IFN-γconcentration of observation group was significantly higher than control group(t=4.87,P<0.0001),and the IL-10 concentration was significantly lower than control group(t=17.95,P<0.0001).(3)At the 7 days post surgery,the concentration of serum IFN-γand IL-10 in both groups decreased significantly,but the IFN-γconcentration of observation group was still higher than control group(t=6.17,P<0.0001),meanwhile,the IL-10 concentration was still lower than control group(t=2.37,P<0.0001).Conclusion:Storage autologous blood transfusion does not affect the expression of IFN-γin patients undergoing elective surgery,the IL-10 express higher in allogeneic blood transfusion group is associated with immunosuppression.

关 键 词：贮存式自体输血 异体输血 择期手术 干抗素-γ IL-10 

分 类 号：R457.1[医药卫生—治疗学]