【摘要】 目的探讨回收式自体输血对机体凝血状态和T淋巴细胞亚群,NK细胞功能的影响。方法选择骨科大手术病人40例,随机分为回收式自体输血组和异体输血组。分别取术前、输血后1h及输血后24h的静脉血,测定血常规,部分凝血酶原时间(APTT),凝血酶原时间(PT),纤维蛋白原(FIB)及活化凝血时间(ACT),同时应用流式细胞仪测定输血后第1天、第5天两组病人T淋巴细胞亚群CD3+、CD4+、CD8+、自然杀伤细胞(NK细胞),并计算CD4+/CD8+值。结果输血后1h两组APTT、PT、ACT均延长,FIB和血小板计数均降低(P<0.05)但尚在正常范围内,两组间比较差异无显著性(P>0.05)。与术前比较,异体输血组输血后第1天和第5天CD3+、CD4+、NK细胞数量显著减少(P<0.01),回收式自体输血组上述指标无明显变化(P>0.05)。结论回收式自体输血对凝血功能的影响与异体输血相似,回收式自体输血对机体细胞免疫功能无明显抑制作用。更多还原

【Abstract】 [Objective] To investigate the changes in blood coagulation and T-Lymphocyte subset and natural killer cell after blood salvage and homologous blood transfusion.[Methods] 40 patients undergoing elective orthopedic surgery were randomly divided into 2 groups:blood salvage group and homologous blood transfusion group.At preoperative,1 h and 24 h after blood transfusion,platelets,PT,APTT,FIB and ACT were measured.On 1st and 5th postoperation for determination of T-lymphocyte subsets and natural killer cell counts by flow cytometry and account CD4+/CD8+.[Results] After blood transfusion,APTT,PT,ACT prolonged significantly,FIB and platelets decreased in these groups(P <0.05),There was no significant difference between the two groups.In homologous blood transfusion group,the number of CD3+,CD4+,CD4+/CD8+,NK cell was decreased obvious on 1st and 5th postoperation when compared with preoperation(P <0.01).But in the bood salvage group,the changes of CD3+,CD4+,CD4+/CD8+,NK cell were unsignificant.[Conclusion] Intraoperative blood salvage and reinfusion does not induce significant change of blood coagulation as compared with allogenic blood trasfusion.The influence of blood salvage and retransfusion on immune function is slight.更多还原