ANIH对老年直肠癌根治术患者围术期NK细胞、NKT细胞和Th1/Th2的影响  

Impact of Acute Non-normovolemic Hemodilution on Perioperative NK Cell,NKT cell and Th1/Th2 in Elderly Patients Undergoing Rectal Carcinoma Radical Resection

作　　者：瞿意隐 郑思媛[2] 戴春宇[1] 张毅[1] QU Yiyin;ZHENG Siyuan;DAI Chunyu;ZHANG Yi(Dept.of Anesthesiology,The Third Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650118;Dept.of Anesthesiology,Chengdu Second People’s Hospital,Chengdu Sichuan 610017,China)

机构地区：[1]昆明医科大学第三附属医院麻醉科,云南昆明650118 [2]成都市第二人民医院麻醉科,四川成都610017

出　　处：《昆明医科大学学报》2022年第2期128-133,共6页Journal of Kunming Medical University

基　　金：贝朗麻醉科学研究基金资助项目(2014)。

摘　　要：目的观察急性非等容量血液稀释(acute nonnormovolemic hemodilution,ANIH)对于老年直肠癌根治术患者围术期NK细胞数量和毒性功能、NKT细胞数量及Th1/Th2细胞因子比值的影响。方法40例最终入选老年患者分为常规输液组(Ⅰ组,n=20)和ANIH组(Ⅱ组,n=20)。所有患者分别于麻醉前1 d(T1)、术后第1天(T2)、第3天(T3)、第7天(T4)抽取外周静脉血,以EPICS XL流式细胞仪检测外周血单核细胞中NK细胞数量和细胞毒性功能、NKT细胞数量、血清Th1型及Th2型细胞因子浓度,计算Th1/Th2型细胞因子比值。结果与T1时比较,2组NK细胞数量T2和T3时都有升高,T3时Ⅱ组升高与Ⅰ组相比差异有统计学意义(P<0.05);T4时2组都明显减少(P<0.05),Ⅰ组减少的程度明显大于Ⅱ组(P<0.05)。与T1时比较,NK细胞毒性T2时2组均有所减少,Ⅰ组减少更为明显(P<0.01),T3时2组均显著增加(P<0.05),Ⅱ组增加更为明显(P<0.05),T4时2组均降低,基本恢复到T1时水平。与T2时比较,T3时2组NKT细胞数量都明显增高(P<0.05),Ⅱ组升高明显(P<0.05)。T4时2组均降低,相比无统计学差异(P>0.05)。2组Th1/Th2型细胞因子比值在各时间点,组间差异均无统计学意义(P>0.05)。结论ANIH与常规输液相比可以保护和改善老年直肠癌根治术患者围术期细胞免疫功能,是一种安全有效的血液保护方法。Objective To investigate the impact of acute non-normovolemic hemodilution(ANIH)on the numbers of NK cell,the NK cell cytotoxicity,numbers of NKT cell and the ratio of Th1/Th2 cytokines in elderly patients undergoing rectal carcinoma radical resection.Methods Forty patients undergoing rectal carcinoma radical resection in the final date analysis were divided into two groups:Conventional Infusion(Group Ⅰ,n=20)and ANIH(Group Ⅱ,n=20).The venous blood samples were taken at 1 day before surgery(T1),at the first day after surgery(T2),the third day after surgery(T3)and the seventh day after surgery(T4)and measured the numbers of NK cell,NKT cell,Th1 and Th2 cytokines as well as the function of NK cell cytotoxicity by flow cytometry.Then we calculated the rate of Th1/Th2 to observe its variation trend.Results Compared with groups at T1,the NK cell numbers of the two groups at T2 and T3 both increased and the growth of cell numbers from group Ⅱ had significant statistical deference with that of group Ⅰ at T3(P<0.05).Oppositely the data of both groups reduced at T4(P<0.05)and the reduction from group Ⅰ was obviously greater than group Ⅱ(P<0.05).Compared with T1,the function of NK cell cytotoxicity of both groups decreased at T2,and the change of group Ⅰ was more obviously(P<0.01).At T3 both groups increased markedly and compared with T1 and T2 it had statistical difference(P<0.05).The data from group Ⅱ rised higher than group Ⅰ(P<0.05).The data from both groups decreased at T4,which almost restore to T1 level.Compared with T2,the NKT cell number of both groups elevated at T3(P<0.05),and the augment of group Ⅱ was more than group Ⅰ(P<0.05).At T4 the number of both groups went lower than at T3,and there was no significant statistical difference between of two groups.The change of Th1/Th2 made no sense from statistical perspective between two groups at any time point(P>0.05).Conclusion Compared with conventional infusion,ANIH can protect and improve the perioperation cellular immunity in elderly patients

关 键 词：血液稀释 直肠肿瘤 NK细胞 NKT细胞 TH1/TH2 

分 类 号：R459[医药卫生—治疗学]