自体血回输对多脏器损伤患者血液流变学、免疫功能及炎性因子的影响
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摘要
目的:探讨自体血回输对外伤性多脏器损伤患者血液流变学、免疫功能、炎性因子的影响。方法:选取2016-07—2018-07收治的86例外伤性多脏器损伤患者,按不同输血方法将患者分为观察组(43例)和对照组(43例),观察组患者行自体血回输,对照组患者行异体输血,对2组患者输血前、输血后7 d血液流变学、免疫功能、炎性因子进行观察。结果:2组患者输血前血液流变学差异无统计学意义(P>0.05),观察组输血前、输血后7 d血浆黏度(PV)、血细胞比容(PCV)、血沉(ESR)、全血高切、低切黏度指标比较差异无统计学意义(P>0.05),观察组输血后7 d上述指标与同期对照组比较差异有统计学意义(P<0.05)。2组异体血输血量比较,差异有统计学意义(P<0.05)。2组输血前CD3~+、CD4~+、NK细胞水平差异无统计学意义(P>0.05),观察组输血后7 d上述指标较本组输血前差异无统计学意义,与同期对照组比较,差异有统计学意义(P<0.05)。2组输血前白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)比较,差异无统计学意义(P>0.05),观察组输血后7 d上述指标与同期对照组比较,差异有统计学意义(P<0.05)。2组输血不良反应率差异无统计学意义(P>0.05)。结论:相较于异体输血,自体血回输对外伤性多脏器损伤患者血液流变学及免疫功能影响更小,并能减轻其炎症反应,且安全性较高,值得推广。
Objective:To investigate the influence of autologous blood transfusion on hemorheology,immune function and inflammatory factors in the patients with traumatic multiple organ injury. Method:86 patients with traumatic multiple organ injury who treated in our hospital from July,2016 to July,2018 were selected,and the patients were divided into observation group(43 cases)and control group(43 cases)according to different blood transfusion methods.The observation group were received autologous blood transfusion,while the control group were received allogeneic blood transfusion.The hemorheology,immune function and inflammatory factors before and after transfusion for 7 days of two groups of patients were observed. Result:There was no significant difference in hemorheology between the two groups before transfusion(P>0.05).There was no significant difference in plasma viscosity(PV),packed cell volume(PCV),erythrocyte sedimentation rate(ESR),whole blood high,low shear viscosity before and after transfusion for 7 days in the observation group(P>0.05).The above indexes after transfusion for 7 days in the observation group were significantly different from those in the control group(P<0.05).There was significant difference in the amount of allogeneic blood transfusion between the two groups(P<0.05).There was no significant difference in the levels of CD3~+,CD4~+,NK cells between the two groups before transfusion(P>0.05).Compared with that before blood transfusion,there was significant difference in the above indexes after blood transfusion for 7 days in the observation group,and compared with the control group in the same time,which was significantly higher(P<0.05).There was no significant difference in the levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-alpha(TNF-α)between the two groups before transfusion(P>0.05).The above indexes after blood transfusion for 7 days in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the adverse reaction rate of blood transfusion between the two groups(P>0.05).Conclusion:Compared with allogeneic blood transfusion,autologous blood transfusion had less influence on hemorheology and immune function of patients with traumatic multiple organ injury,and could alleviate inflammation,which would be safe and worth popularizing.
Objective:To investigate the influence of autologous blood transfusion on hemorheology,immune function and inflammatory factors in the patients with traumatic multiple organ injury. Method:86 patients with traumatic multiple organ injury who treated in our hospital from July,2016 to July,2018 were selected,and the patients were divided into observation group(43 cases)and control group(43 cases)according to different blood transfusion methods.The observation group were received autologous blood transfusion,while the control group were received allogeneic blood transfusion.The hemorheology,immune function and inflammatory factors before and after transfusion for 7 days of two groups of patients were observed. Result:There was no significant difference in hemorheology between the two groups before transfusion(P>0.05).There was no significant difference in plasma viscosity(PV),packed cell volume(PCV),erythrocyte sedimentation rate(ESR),whole blood high,low shear viscosity before and after transfusion for 7 days in the observation group(P>0.05).The above indexes after transfusion for 7 days in the observation group were significantly different from those in the control group(P<0.05).There was significant difference in the amount of allogeneic blood transfusion between the two groups(P<0.05).There was no significant difference in the levels of CD3~+,CD4~+,NK cells between the two groups before transfusion(P>0.05).Compared with that before blood transfusion,there was significant difference in the above indexes after blood transfusion for 7 days in the observation group,and compared with the control group in the same time,which was significantly higher(P<0.05).There was no significant difference in the levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-alpha(TNF-α)between the two groups before transfusion(P>0.05).The above indexes after blood transfusion for 7 days in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the adverse reaction rate of blood transfusion between the two groups(P>0.05).Conclusion:Compared with allogeneic blood transfusion,autologous blood transfusion had less influence on hemorheology and immune function of patients with traumatic multiple organ injury,and could alleviate inflammation,which would be safe and worth popularizing.
引文
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[8] 吴钢,罗政,尹锐,等.术中自体血回输与输注异体血对脊柱手术术后血液流变学的影响[J].骨科,2018,9(2):107-111.
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[10] 黄凯.CRP与ESR在骨科内固定手术后的表达变化及意义[J].标记免疫分析与临床,2016,23(8):874-877.
[11] 倪宏云,刘宏敏,韩凤英,等.自体血回输对外伤性多脏器损伤患者免疫功能指标的影响[J].临床血液学杂志,2016,29(12):967-969.
[12] 徐消寒,张卫.回收式自体输血与异体输血对机体炎症反应的影响[J].国际麻醉学与复苏杂志,2015,36(1):44-46.
[13] 王于昌,解杰,白祥军,等.自体血回输对多发伤损伤控制性手术患者炎性细胞因子的影响[J].临床急诊杂志,2016,17(7):500-502.
[14] 李杰,周玉旺.自体血回输对全麻骨科手术患者炎性细胞因子的影响[J].临床血液学杂,2016,29(6):503-505.
[2] Salamin O,De Angelis S,Tissot JD,et al.Autologous Blood Transfusion in Sports:Emerging Biomarkers[J].Transfus Med Rev,2016,30:109-115.
[3] 单明华.226例输血反应临床分析[J].北京医学,2014,36(11):966-967.
[4] 车辑.回收式自体输血的临床应用与存在的问题[J].中国临床医生杂志,2017,45(7):1-3.
[5] 钟青,谭军,欧阳玲.术中自体血液回输对颅脑手术患者免疫功能的影响[J].皖南医学院学报,2017,36(6):579-581.
[6] 夏敏,王凌,周旺辉,等.自体血液回输对全麻手术患者免疫状态及感染的影响研究[J].中华医院感染学杂志,2017,27(5):1066-1069.
[7] 唐加华,吕毅,芶大明,等.自体血回输技术对行脊柱内固定手术患者术后血液流变学和骨折愈合的影响[J].昆明医科大学学报,2016,37(7):78-81.
[8] 吴钢,罗政,尹锐,等.术中自体血回输与输注异体血对脊柱手术术后血液流变学的影响[J].骨科,2018,9(2):107-111.
[9] Tang JH,Lyu Y,Cheng LM,et al.Risk Factors for the Postoperative Transfusion of Allogeneic Blood in Orthopedics Patients With Intraoperative Blood Salvage[J].Medicine,2016,95:2866-2875.
[10] 黄凯.CRP与ESR在骨科内固定手术后的表达变化及意义[J].标记免疫分析与临床,2016,23(8):874-877.
[11] 倪宏云,刘宏敏,韩凤英,等.自体血回输对外伤性多脏器损伤患者免疫功能指标的影响[J].临床血液学杂志,2016,29(12):967-969.
[12] 徐消寒,张卫.回收式自体输血与异体输血对机体炎症反应的影响[J].国际麻醉学与复苏杂志,2015,36(1):44-46.
[13] 王于昌,解杰,白祥军,等.自体血回输对多发伤损伤控制性手术患者炎性细胞因子的影响[J].临床急诊杂志,2016,17(7):500-502.
[14] 李杰,周玉旺.自体血回输对全麻骨科手术患者炎性细胞因子的影响[J].临床血液学杂,2016,29(6):503-505.