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目的探讨不同的输血方式在围术期内对患者的相关炎性因子以及免疫球蛋白水平的影响,以寻求最佳的围术期输血方式。方法选择2013年4月至2016年4月在本院接受手术治疗的84例围术期输血患者,按照随机原则分为2组,其中自体组患者采取自体输血方式,而另42例患者采用异体输血的方式,对比2组患者在术前、术后第1天、术后第7天时的炎性因子白介素-1β(IL-1β)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TN F-α)以及免疫球蛋白水平IgG、IgA、IgM的水平。结果 2组患者术后的IgG、IgA均出现了一定程度下降,和术前相比差异有统计学意义(P<0.05),同时异体输血组下降程度更重,远远超过自体组,差异有统计学意义(P<0.05);而术后第7天2组患者的免疫球蛋白水平均有所回升,但异体组回升速度明显不及自体组,差异有统计学意义(P<0.05);此外,在术后第1天,2组患者的IL-1β同时出现升高现象,但与术前相比差异无统计学意义(P>0.05),而IL-6、IL-8、TN F-α则有明显的升高(P<0.05);而在术后第7天,自体组患者的IL-6、IL-8、TN F-α仍明显高于异体组(P<0.05)。结论相比于异体输血,自体输血应用于围术期患者中在提高炎性因子和调控免疫球蛋白水平方面更具优势,故对其免疫功能的影响程度更小、更安全,也一定程度的减少了术后感染的发生率。
Objective To explore the influence of different transfusion methods on the related inflammatory factors and immunoglobulin levels in patients during perioperative period in order to find out the optimal perioperative blood transfusion. Methods Eighty-four perioperative patients undergoing transurethral resection in our hospital from April 2013 to April 2016 were divided into two groups according to the principle of randomization. The autologous blood transfusion was used in the autologous group while the other 42 patients were treated with allogeneic Transfusion of blood were compared between the two groups in preoperative, postoperative day 1, postoperative day 7 inflammatory cytokines interleukin-1β (IL-1β), interleukin -6 (IL-6), interleukin -8 (IL -8), tumor necrosis factor-α (TN F-α) and immunoglobulin levels of IgG, IgA, IgM. Results The postoperative IgG and IgA levels in both groups decreased to a certain extent compared with that before operation (P <0.05), meanwhile, the levels of IgG and IgA decreased more significantly in allogeneic transfusion group than in autologous group (P <0.05). On the 7th day after operation, the immunoglobulin levels recovered in both groups, but the recovery rate in allogeneic group was significantly lower than that in autologous group (P <0.05). In addition, The levels of IL-1β in the two groups increased at the same time, but there was no significant difference compared with that before operation (P> 0.05). The levels of IL-6, IL-8 and TN F- (P <0.05). On the 7th day after surgery, the levels of IL-6, IL-8 and TN F-α in patients with autologous were significantly higher than those in allogeneic patients (P <0.05). CONCLUSIONS: Compared with allogeneic transfusion, autologous blood transfusion has more advantages in improving perioperative patients’ ability to regulate inflammatory cytokines and immunoglobulin levels and thus has less impact on immune function, and to a certain extent, Reduce the incidence of postoperative infection.