术中自体血回收对红细胞免疫功能及其免疫受体的影响

目的 自体血回收对红细胞的免疫功能及其膜表面免疫受体的数量的影响.方法 随机选择全髂关节或股骨头置换的择期手术患者16例,术中取术野血和回收血各5 ml,测定红细胞C50>b受体花环率(RCR)和红细胞免疫复合物花环率(RCIR),以及红细胞表面CD35和CD58受体数量.结果 术野血和回收血的RCR分别为32.3%±6.9%和25.6%±5.0%.RCIR分别为13.3%±6.8%和7.9%±1.6%,回收血的RCR和RCIR均明显低于术野血(P<0.05).回收血红细胞膜表面CD35和CD58的荧光强度分别为27.6±1.9和21.4±3.3,均明显低于术野血CD35(35.1±4.4,P<0.01)和CD58(27.3±5.5,P<0.05)的荧光强度.结论 目前采用的自体血回收技术对红细胞的免疫功能有一定抑制作用,其机制可能与红细胞表面免疫受体的数量减少有关.

Influence of intraoperative blood cell salvage on erythrocyte immunity and immunoreceptor expression

Objective To investigate the influence of intraoperative blood cell salvage on erythrocyte immunity and the expression of CD35 and CD58. Methods Sixteen patients undergoing total hip replacement or artificial femoral head arthroplasty were chosen. Blood (5 ml) was collected from operation field and from cell saver, respectively to measure rosette rate of RBC · C3b receptor (RCR) and immune complex rosette rate of red cell (RICR). The expression of CD35 and CD58 on erythrocytes was detected with flow cytometer. Results Both RCR and RICR from cell saver, and the expression of CD35 and CD58 on erythrocytes from cell saver were significantly lower than those from operation field. Conclusion Intraoperative salvage of blood cells inhibits the erythrocyte immunity, which may be related to the inhibition of CD35 and CD58 expression on erythrocytes.