围术期输血对T淋巴细胞亚群、NK细胞变化和血清sIL-2R水平变化的影响及临床意义

目的 探讨输入异体全血和盐水、腺嘌呤、葡萄糖、甘露醇处理后红细胞血（ＳＡＧ－Ｍ红细胞血）后，Ｔ淋巴细胞亚群，ＮＫ细胞数量和血甭可溶性白介素２受体（ｓＩＬ－２Ｒ）水平的变化，为临床合理输血提供实验依据。方法 直肠癌根治手术患者３０例，随机分为２ Ⅰ组（ｎ＝１５）术中输血这异体全血这异体，Ⅱ组（ｎ＝１５）术中输血为ＳＡＧ－Ｍ红细胞血，术中输血量均为４００ｍｌ。用间接免疫荧光法和双抗夹心ＥＬＩＳＡ法，检

Influences of perioperative blood transfusion on T-lymphocyte subsets, natnral killer cell and soluble interleukin-2 receptor

Objective To investigate the changes in counts of T-lymphocyte subsets, natural killer cell (NK cell) and the levels of serum soluble interleukin-2 receptor(sIL-2R) after perioperative allogeneic whole-blood transfusion or erythrocyte suspention (SAG-M blood) blood transfusion. Methods Thirty patients undergoing elective refection for rectal cancer, were randomly allocated to receiving 400 ml of allogeneic whole-blood (n = 15 ) or 400 ml of SAG-M blood (n = 15 ) during perioperative period, respectively. Indirect immunofluorescence technique and enzyme-linked immunosorbent assay were used to determine the counts of T--lymphocyte subsets, NK cells and to detect levels of serum sIL-2R 1 day and 5 day after operation.Results The counts of CD3 , CD. and NK cells in both groups decreased significantly after operation (P < 0. 01 ). The decreases in counts of CD3 , CD4 and NK cells in allogeneic whole-blood transfusion group were much more than those in SAG-M blood transfusion group 5 day after operation (P< 0. 05). sIL-ZR level elevated greatly after operation(P< 0. 01 ), the increase of which was more obvious in allogeneic whole-blood transfusion group than in SAG-M blood transfusion group (P < 0.01 ). There were significantly negative correlations between sIL-2R level and counts of CD3 , CD4 or NK cells after operation in allogeneic blood transfusion group(r = - 0. 55, - 0. 59 - 0. 62, P < 0 .05). Conclusions Perioperative blood transfusion contributes to the immunosuppression, which is more serious after whole-blood transfusions than after SAG-M blood transfusion. In perioperative period component blood transfusion is superior to whole-blood transfusion.