预存式自体输血对原发性肝癌患者围术期免疫功能的影响  

Effect of preoperative autologous blood donation on perioperative immune function in patients with primary liver cancer

作　　者：龚由伟 薛颖泓 唐涌连[1] 姜衡春[1] 郑泽斌 陈铃[1] Gong Youwei;Xue Yinghong;Tang Yonglian;Jiang Hengchun;Zheng Zebin;Chen Ling(Department of Blood Transfusion,Guangxi Medical University Affiliated Tumor Hospital,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院输血科,南宁530021

出　　处：《广西医科大学学报》2020年第9期1648-1652,共5页Journal of Guangxi Medical University

基　　金：广西自然科学基金资助项目(No.2019GXNSFDA245001)。

摘　　要：目的:观察预存式自体输血(PABD)对原发性肝癌患者围手术期机体免疫功能的影响。方法:选取2017年1月到2019年4月在广西医科大学附属肿瘤医院接受手术治疗的原发性肝癌患者105例,按照输血方式分为自体输血组、异体输血组、未输血组,每组35例。手术前和手术后的第1天、第5天检测免疫细胞和免疫蛋白的变化。结果:术前3组患者的免疫功能指标辅助性T细胞(Th)、抑制性T细胞(Ts)、Th/Ts、NK细胞、IgG、IgM和IgA等比较,差异无统计学意义(P>0.05)。与术前比较,术后第1天,3组患者的Th、Th/Ts、NK细胞均下降(P<0.05);自体输血组与未输血组的Th、Th/Ts、NK细胞水平高于异体输血组(P<0.05);异体输血组的IgG、IgM和IgA水平较术前显著降低(P<0.05),自体输血组与未输血组的IgG、IgM和IgA水平无明显变化,且均显著高于高于异体输血组(P<0.05)。术后第5天,自体输血组、未输血组的各项免疫指标方面都基本恢复,且除Ts指标外均高于异体输血组(P<0.05);异体输血组各项免疫指标还未恢复至术前水平(P<0.05)。结论:与异体输血比较,PABD对原发性肝癌患者围手术期机体免疫功能的影响较小,选择PABD方式能减轻肝癌手术患者的免疫抑制。Objective:To observe the effect of preoperative autologous blood donation(PABD)on the perioperative immune function of primary liver cancer patients.Methods:105 patients with primary liver cancer who underwent surgery at Guangxi Medical University Affiliated Tumor Hospital from January 2017 to April 2019 were selected and divided into autologous group,allogeneicgroup,and non-transfusion groups according to the blood transfusion method,with 35 patients in each group.The changes of immune cells and immune proteins were detected before and after the 1st and 5th day of surgery.Results:There was no significant difference inthe immune function indexes of helper T cells(Th),suppressor T cells(Ts),Th/Ts,NK cells,IgG,IgM,and IgA among the 3 groups before surgery(P>0.05).Compared with the preoperative period,the Th,Th/Ts,and NK cells ofthe three groups were decreased on the 1stday after surgery(P<0.05);the levelsof Th,Th/Ts,and NK cell in theautologous group and the non-transfusion groupwere higher than thosein the allogeneic group(P<0.05);the levelsof IgG,IgM,and IgA were significantly lower in the allogeneic group compared with the preoperative period(P<0.05),the levels of IgG,IgM,and IgA in the autologous and non-transfusion group did not change significantly and were significantly higher than those in the allogeneic group(P<0.05).On the 5thday afteroperation,the immune function indexes of the autologous group and the non-transfusion group were basically recovered,and were higher than those of the allogeneic transfusion group(P<0.05);the immune function indexes of the allogeneic group had not recover to the preoperative level(P<0.05).Conclusion:Compared with allogeneic blood transfusion,PABD has less effect on the immune function of primary liver cancer patients during the perioperative period.Therefore,the choice of PABD can reduce the immunosuppression of liver cancer patients.

关 键 词：原发性肝癌 自体输血 异体输血 免疫功能 

分 类 号：R735.7[医药卫生—肿瘤]