摘要
目的 :通过检测直肠癌患者术中输入异体全血和SAG -M红细胞血后 ,白介素 6 (IL - 6 )和血清可溶性白介素 2受体 (sIL - 2R)水平的变化 ,以探讨围术期输血对机体免疫功能抑制规律及其机制 ,为临床合理输血提供实验依据。方法 :直肠癌根治手术患者 30例 ,随机分为 2组 :输异体全血组 (n =15 ) ;输SAG -M红细胞血组 (n =15 )。双抗夹心ELISA法 ,检测术前、术后 1d和术后 5d血清IL - 6及血清sIL - 2R水平。结果 :输异体全血组或SAG -M红细胞血组患者IL - 6、sIL - 2R术后均显著升高 ,输异体全血组较输SAG -M组升高有显著性差异。结论 :输血后血清IL - 6及血清sIL - 2R水平增高 ,与免疫功能抑制密切相关。输异体全血比输SAG -M红细胞血对免疫功能的损伤更为严重。提示围术期应尽量少输血 ,特别是癌症患者更应注意。以成分输血优于输全血。
Objective: To investigate the changes in the levels of serum IL-6 and sIL-2R after perioperative allogenic blood transfusion or SAG-M red cells blood transfusion. Methods:Thirty patients with rectal cancer were selected and randomized for the use of allogenic blood transfusion (group Ⅰ,n=15)400ml, SAG-M red cell blood transfusion (group Ⅱ, n=15)400ml.Preoperative Hb of all patients was over 110g/L. Patients with endocrine immunological, liver or kidney disease and those who had received radio-or chemotherapy were excluded. No cortical hormone was used during preoperative period. The patients were premedicated with Phenobarbital 0.1. Epidural block was performed at T 10～12 and L 3～4 .1.5%lidocaine 10～15ml was injected. Peripheral venous blood samples were taken before operation and 1 st , 5 th postoperative day for determination of the levels of serum IL-6 and sIL-2R by enzyme linked immunosorbent assay (ELISA). Results:Compared with the baseline on 1 st and 5 th postoperative day IL-6 and sIL-2R all increased significantly in both groups. It was more obvious in allogenic blood transfusion group than in SAG-M red cell blood transfusion group. Conclusion: Perioperative blood transfusion contributes to the increase of IL-6, sIL-2R, which is associated with immunosuppression. The immune function was impaired more seriously in allogeneic blood transfusion group than in SAG-M red cell blood transfusion group. In perioperative period component blood transfusion is superior to whole blood transfusion.
出处
《中国现代医学杂志》
CAS
CSCD
2003年第11期68-70,共3页
China Journal of Modern Medicine
