3种输血方式对高危产妇围术期免疫功能的影响

目的 探讨3种输血方式对高危产妇围术期免疫功能的影响。方法 回顾性分析2018年2月至2020年3月佛山市高明区人民医院收治的120例高危产妇的临床资料，根据不同输血方式，分为自体组、混合组（同时输自体和异体血）和异体组，每组40例。比较3组产妇一般情况以及手术前后外周血T细胞亚群、免疫球蛋白和补体C3水平的差异。结果 自体组产妇手术前后CD4⁺/CD8⁺差值为（0.18±0.08），混合组为（0.43±0.16），异体组为（0.78±0.28），差异有统计学意义（P<0.05）。自体组产妇手术前后免疫球蛋白G水平差值为（0.42±0.13）g/L，混合组为（3.52±0.96）g/L，异体组为（6.14±1.78）g/L，差异有统计学意义（P<0.05）。自体组产妇手术前后免疫球蛋白A水平差值为（0.17±0.08）g/L，混合组为（1.02±0.28）g/L，异体组为（1.32±0.30）g/L，差异有统计学意义（P<0.05）。自体组产妇手术前后C3水平差值为（0.49±0.23）g/L，混合组为（0.22±0.14）g/L，异体组为（0.04±0.02）g/L，差异有统计学意义（P<0.05）。结论 在3种输血方式中，自体输血对高危产妇围术期免疫功能影响最小，建议临床采用此输血方式。

Influence of three blood transfusion methods on perioperative immune function of high risk parturient

Objective To explore the influence of three blood transfusion methods on perioperative immune function of high-risk parturient. Methods The clinical data of 120 high-risk parturients admitted to Gaoming District People''s Hospital of Foshan City from February 2018 to March 2020 were retrospectively analyzed. According to different blood transfusion methods, 120 high-risk parturients were divided into autologous group, mixed group (both autologous and allogeneic blood transfusion) and allogeneic group, with 40 cases in each group. The general conditions of the three groups of patients and the differences of peripheral blood T cell subsets, immunoglobulin and complement C3 levels before and after surgery were compared. Results The difference of CD4⁺/CD8⁺ before and after operation was (0.18±0.08) in autologous group, (0.43±0.16) in mixed group and (0.78±0.28) in allogeneic group, with statistical significance (P<0.05). The level difference of immunoglobulin G before and after operation was (0.42±0.13) g/L in autologous group, (3.52±0.96) g/L in mixed group and (6.14±1.78) g/L in allogeneic group, with statistical significance (P<0.05). The level difference of immunoglobulin A before and after operation was (0.17±0.08) g/L in autologous group, (1.02±0.28) g/L in mixed group and (1.32±0.30) g/L in allogeneic group, with statistical significance (P<0.05). The difference of C3 level before and after operation was (0.49±0.23) g/L in autologous group, (0.22±0.14) g/L in mixed group and (0.04±0.02) g/L in allogeneic group, with statistical significance (P<0.05). Conclusion Among the three blood transfusion methods, autologous blood transfusion has the least influence on perioperative immune function of high-risk parturients, so it is recommended to adopt this blood transfusion method clinically.