体外循环心脏瓣膜替换术对机体免疫功能的影响

探讨体外循环心脏瓣膜替换术对机体免疫功能的影响。动态检测３０例心脏瓣膜替换病人术前和术后１、３、７、１４天多项细胞和体液免疫功能指标。结果显示：术后早期Ｔ、Ｂ淋巴细胞数目减少，亚群分布异常，淋巴细胞转化率及转化后白细胞介素２受体阳性表达细胞数低下；红细胞免疫功能降低；血中免疫球蛋白浓度及其诱生能力低下，血中补体水平低下和Ｃ反应蛋白增高。结论：体外循环换瓣术后机体免疫功能受到明显抑制，是术后易发感染的主要原因，应强调围术期采用综合性预防感染措施的重要性

Effect of Cardiopulnonary Bypass During Valve Replacement on Humau Immune Function

Aim:This study was undertaken to determine the effect of cardiopulmonary bypass(CPB) on human immune function.Clinical material and method:30 patients undergoing cardiac valve replacement were randomly selected and the changes of cellular and humonal immune function were studied preoperatively,and on the first,third,seventh and fourteenth postoperative days.Results:The T and B lymphocyte counts,percentage of CD 4 cells,CD 4/CD 8 ratio,PHA activating lymphocyte transfer rate and interleukin 2 recepter positive expression lymphocyte count,red blood cell immune adherence function,plasma levels of immunoglobin(IgG,IgA and IgM)and complement fraction(C 3,C 4,CH 50 ),IgG production and plasma C reactive protein were measured.Result:Except C reactive protein level increased,all other parameters studied were decreased significantly on the early postoperative days as compared with preoperative values(P<0.05).All these parameters returned to preoperative levels within 7 to 14 days.Conclusion:The human immune function was significanlty depressed for at least one week following CPB.It was demonstrated that all effective measures should be taken to offer sufficient protection against infection.