人工关节置换术中预存式联合自体回收式输血患者免疫功能和炎症因子的变化及相关性分析  

Changes and Correlation Analysis of Immune Function and Inflammatory Factors Levels in Patients with Prestored Combined Autologous Blood Transfusion in Artificial Joint Replacement

作　　者：严威 靳情 朱贵忠 方静 孙锐 YAN Wei;JIN Qing;ZHU Gui-zhong;FANG Jing;SUN Rui(Department of Blood Transfusion,Xiangyang No.1 People's Hospital,Hubei University of Medicine,Xiangyang,Hubei,441000,China;Department of Clinical Laboratory,Xiangyang Hospital of Traditional Chinese Medicine(Xiangyang Institute of Traditional Chinese Medicine),Xiangyang,Hubei,441000,China;Department of Clinical Laboratory,Xiangyang First People's Hospital Affiliated to Hubei Medical College,Xiangyang,Hubei,441000,China,China;Department of Oncology,Wuhan Fourth Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei,430032,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院输血科,湖北襄阳441000 [2]湖北省襄阳市中医医院(襄阳市中医药研究所)检验科,湖北襄阳441000 [3]湖北医药学院附属襄阳市第一人民医院检验科,湖北襄阳441000 [4]华中科技大学同济医学院附属武汉市第四医院肿瘤科,湖北武汉430032

出　　处：《现代生物医学进展》2020年第7期1364-1367,1388,共5页Progress in Modern Biomedicine

基　　金：湖北省科技计划项目(2016CFB340);武汉市卫生健康科研基金项目(WX19D65)。

摘　　要：目的:探讨人工关节置换术中预存式联合自体回收式输血患者免疫功能和炎症因子水平的变化,并分析免疫功能和炎症因子的相关性。方法:选取在我院接受人工关节置换术的患者80例,根据随机数字表法将患者分为对照组和观察组。对照组患者行异体输血治疗,观察组行预存式联合自体回收式输血治疗。比较两组患者围术期失血量和输血量,分析两组患者不同时间点的免疫功能指标和炎症因子水平的变化及其相关性,统计两组患者术后出现的不良反应。结果:两组患者的术中失血量、术后失血量、总失血量和总输血量比较差异无统计学意义(P>0.05)。术后24 h两组患者的CD3^+、CD4^+、CD4^+/CD8^+、自然杀伤细胞(NK)明显降低,且观察组高于对照组(P<0.05),术后24 h两组患者的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平明显升高,且观察组低于对照组(P<0.05)。经Pearson相关性分析显示,IL-6、IL-8、TNF-α均与CD3^+、CD4^+、CD4^+/CD8^+、NK呈负相关(P<0.05)。观察组的不良反应率低于对照组(P<0.05)。结论:人工关节置换术中预存式联合自体回收式输血对患者免疫功能、炎症反应的影响较小,输血安全性较好,且患者的免疫因子和炎症因子相互制约。Objective:To investigate the changes of immune function and inflammatory factors levels in patients with pre stored combined autologous blood transfusion in artificial joint replacement,and to analyze the correlation between immune function and inflammatory factors.Methods:80 patients who were undergone artificial joint replacement in our hospital were selected,and the patients were divided into the control group and the observation group according to the random digital table method.The patients in the control group were treated with allogeneic blood transfusion,and the patient in the observation group was treated with pre stored combined autologous blood transfusion.The amount of postoperative blood loss and blood transfusion were compared between the two groups.The changes and correlation of immune function indexes and inflammatory factors levels of patients in two groups at different time points were analyzed and the adverse reactions of patients in two groups after operation was counted.Results:There was no significant difference in amount of intraoperative blood loss,postoperative blood loss,total blood loss and total blood transfusion between the two groups(P>0.05).The CD3^+,CD4^+,CD4^+/CD8^+and natural killer cells(NK)of patients in the two groups at 24 h after operation were significantly decreased,and the observation group was higher than the control group(P<0.05).The levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in two groups at 24 h after operation were increased significantly,and the observation group was lower than the control group(P<0.05).Pearson correlation analysis showed that IL-6,IL-8 and TNF-αwere negatively correlated with CD3^+,CD4^+,CD4^+/CD8^+and NK(P<0.05),and the adverse reaction rate of the observation group was lower than that of the control group(P<0.05).Conclusion:Pre stored combined autologous blood transfusion in artificial joint replacement has less effect on the immune function and inflammatory response of the patients,the safety of transfu

关 键 词：人工关节置换术 自体输血 异体输血 免疫细胞 炎症因子 相关性 

分 类 号：R687[医药卫生—骨科学] R457.1[医药卫生—外科学]