体外循环心脏手术对机体免疫功能的影响

目的　探讨体外循环心脏直视手术病人围术期细胞和体液免疫功能的变化及其临床意义。方法　选择 45例心脏直视手术病人 ,检测术前、术后 1天、3天、7天和 14天的血清 T淋巴细胞亚群 ,CD3 ( T淋巴细胞总数 )、CD4(辅助 T淋巴细胞 )、CD8(抑制 T淋巴细胞 )、自然杀伤细胞 ( NK)活性和免疫球蛋白水平。结果　术后第 1、3天血清 CD3、CD4、CD8活性明显降低 ,CD4/ CD8比值下降 ,NK细胞活性增强 ;免疫球蛋白均较术前降低。术后 7至 14天逐步恢复至术前水平。结论　体外循环心脏直视手术对患者细胞和体液免疫均有不良影响 ,临床应采取相应措施 ,改善术后病人免疫机能 ,预防术后感染

Effects of cardiopulmonary bypass on immune function

Objective To study the effects of immune function preoperatively and after cardiopulmonary bypass. Methods A total of 45 patients undergoing open-heart surgery by cardiopulmonary bypass were enrolled in this study. T lymphocyte subsets, natural killer (NK) active and immune globulin were measured preoperatively, and1, 3, 7 and 14 days after surgery. Results Compared with those preoperatively, the T lymphocytes subsets, CD3, CD4, CD8 and CD4/CD8 were decreased significantly, however, natural killer active were increased during 1 and 3 days after surgery. The immune globulin IgA, IgG and IgM were decreased significantly during 1 and 3 days, then it went up step by step to the preoperative values in 7 to 14 days after surgery. Conclusion These results indicate that the immune function may be impaired after cardiopulmonary bypass.