心脏直视术后回输胸腔引流血及异体病人T淋巴细胞及其亚群的影响

目的：比较回输心脏直视术后胸腔引流血及异体输血对病人T淋巴细胞及其亚群的影响。方法：20例选择性心脏搭桥手术（CABG）随机分为两组，胸腔引流血回输组（n=10），异体输血组（n=10）。两组病人于麻醉前，术后第2大，第7天检测外周静脉血的CD3，CD4，CD8，CD4/CD8比值。结果：两组病人术前各项指标无明显差异（P〉0．5）。异体输血组病人术后第二天与术前及同输引流血组比较，CD3，CD4，CD8明显下降（P〈0．05）。CD4/CD8无明显改变（P〉0．5）。术后第七天两组指标与术前比较及组间比较无明显差异（P〉0．5）。结论：心脏直视术后胸腔引流血回输对病人T细胞免疫功能影响较小，异体输血对T细胞免疫功能有抑制作用。

Changes of T-Lymphocyte and subset in patients undergoing autotransfusion of shed mediastinal blood or transfusion of bank blood after open heart operation

Objective: This Prospective study was designed to evaluate the effects of autotransfusion of shed mediastinal blood or transfusion of bank blood on T -lymphocyte and subsets in patients undergoing open heart operation. Methods: Twenty patients scheduled for elective open heart operation without immune system disorder or tumor were randomly divided into two group: autotransfusion of shed mediastinal group (n=10) and bank blood group (n=10). Blood samples were taken from peripheral vein before operation, 2 and 7 days after surgery for measurement of CD3,CD4,CD8,CD4/CD8 ratio. Result: The valures of CD3,CD4,CD8,CD4/CD8 ratio were comparable between two groups before operation (P>0.05). CD3,CD4,CD8,valures decreased markedly in bank blood group on the 2nd day after operation as compared with those before operation and autotransfusion group (P <0.05). But there was no significant change in CD4/CDg ratio after operation (P>0.05). On the 7th day after operation these parameters did not differ significantly from those before operation and between two group (P>0.05). Conclusions: Autotransfusion has less effect on patient's T-lymphocyte immune function, while bank blood transfusion can obviously inhibit patient's T-lymphocyte immune function.