应用磷酸肌酸对体外循环患者体液免疫功能的影响

目的　观察外源性磷酸肌酸 (CP)对体外循环 (CPB)患者体液免疫功能的影响。方法　CPB患者均选用冠脉搭桥 (CABG)的围术期患者。将 2 8例CABG患者分为CP组 17例 ,对照组 11例。CP组于术前、后各用CP 3～ 7天 ,每天 2g静脉滴注 ,术中将CP加入心脏停搏液中 ;对照组术前、中、后均不用CP。观察两组患者术前 1周、麻醉诱导后、术中阻断升主动脉后 5min、35min、6 5min、6 5min、术毕、术后 2 4h、术后 1周补体 (C3、C4 )及免疫球蛋白 (IgA、IgG、IgE、IgM)的变化。结果　两组患者补体C3、C4及 4种免疫球蛋白的变化曲线相似 ,在术前 1周、麻醉诱导后、术中阻断升主动脉后 5min、35min、6 5min、术毕、术后 2 4h两组间均无明显差别 ,而术后 1周结果显示CP组补体C3、C4及免疫球蛋白IgG、IgM均明显低于对照组 (P <0 .0 5 )。结论　外源性磷酸肌酸用于CPB患者围术前 ,可以营养细胞 ,保护细胞膜的稳定性 ,使补体和免疫球蛋白不会因手术损伤而应激性增高 ,保护体液免疫功能 ,减少炎症 ,有利于术后患者康复。其机制可能是通过清除ADP实现的

Influence of exogenous creatine phosphate on humoral immune function in CPB

Objective To observe influence of exogenous creatine phosphate on Humoral immune function in CPB.Methods 28 patients were divided into control group ( n =11) and CP group ( n =17). The patients of CP group were given CP before and after operation (2 gram/day intravenous for 3 7 days) and during operation(10 mmol/1 added into cardioplegia). In the other group, patients were not given CP. The changes of complement (C3,C4) and immunoglobulin (IgA, IgG, IgE, IgM) were observed 1 week before operation ,immediately after induction of anesthesia, 5,35, 65 minutes after occlusion of aorta during operation ,immediately after operation, 24 hours and 1 week after operation respectively.Results The changes of C3, C4 and 4 kinds of immunoglobulin were similar in the two groups. All values of completments and immunoglubulin showed no significant diference between the two groups except those of 1 week after operation, In CP group, all values were lower than those of control group, and the values of C3, C4, IgG, IgM are especially lower than those of control group. Conclusion The data indicated that exogenous creatine phosphate used in the patients of CPB perioperatively can nurture cells, protective stability of cells membrane, overt heighten of complement and immunoglobulin on ejection condition, the mechanism may be throgh cleaning ADP.