参附注射液对自体血回输患者围术期体液免疫功能的影响

目的：探讨参附注射液对自体血回输患者围术期体液免疫功能的影响.方法：择期行脊柱手术患者40 例,将其随机分成对照组（C组） 和参附注射液组（SF 组）,每组20 例.C 组采用常规自体血回输法,SF 组于术前3 d 开始注射参附注射液50 ml,1 次/d,连续3 d,术中于收集自体血前30 min,经5 min 静脉输注参附注射液50 ml,并在回收血液的肝素盐水和洗涤盐水内加入参附注射液,每500 ml 加入参附注射液25 ml.于麻醉诱导前（T0）、术后1 h（T1）、1 d（T2） 及5 d（T3） 时取静脉血样,采用ELISA 法测定血清免疫球蛋白（IgG、IgM） 的浓度;记录手术时间、术中出血量、回输血量.结果：两组患者手术时间、术中出血量、回输血量比较差异均无统计学意义（P〉0.05）.与T0 时比较,对照组T1～T3 时血清IgG 和IgM 浓度降低,SF 组T 1、T2 时血清IgG 浓度降低（P〈0.05）,T3 时差异无统计学意义,T1～T3 时血清IgM 浓度差异无统计学意义（P〉0.05） ;与C 组比较,SF 组T2、T3 时血清IgG 浓度、T1～T3 时血清IgM 浓度升高（P〈0.05）.结论：参附注射液可在一定程度上减轻自体血回输患者体液免疫抑制,改善体液免疫平衡状态.

Effect of Shenfu Injection on Perioperative Humoral Immune Function in Patients Required for Autologous Blood Transfusion

Objective：To investigate the effect of Shenfu injection on humoral immune function in patients required for autolngous blood transfusion. Method：Sixty ASA I or II patients undergoing elective spinal surgery were randomly divided into 2 groups （n=20 each）：Shenfu group and control group.In Shenfu group, Shenfu injection 50 ml was infused intravenously over 5 min at 30 min before the autologous blood was collected. Shengfu injection was added to the heparinized saline and washing saline at the same time （25 ml） until the final concentration reached 0.005%. Shenfu injection was not given in control group. Venous blood samples were taken before anesthesia induction （TO） and at 1 h after operation （T1）, and on day 1 and 5 after operation （T2-T3） for measurement of serum IgG and IgM concentrations by ELISA. The operation time, intraoperative blood loss and amount of salvaged blood reinfused were recorded.Result：There was no significant difference in the operation time, intraoperative blood loss and amount of salvaged blood reinfused between the two groups （P〉0.05）. Compared with the baseline value at TO, serum IgG and IgM concentrations were significantly decreased at T1-T3 in control group and the serum IgG concentration was significantly decreased at T1, T2 in Shenfu group （P〈0.05）. The serum IgG concentration at T2, T3 and serum IgM concentration at T1-T3 were significantly increased in Shenfu group than in control group （P〈0.05）.Conclusion：Shenfu injection can reduce humoral to some extent and improve the balance of humoral immunity in patients required for autologous blood transfusion.