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临床输血与检验

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (4): 352-354.DOI: 10.3969/j.issn.1671-2587.2019.04.005

• 临床输血 • 上一篇    下一篇

去白细胞红细胞输血对严重创伤患者免疫功能和炎症因子的影响

芦璐, 高阳   

  1. 250031 山东省立第三医院输血科
  • 收稿日期:2017-11-21 出版日期:2019-08-20 发布日期:2019-08-28
  • 通讯作者: 高阳,女,山东济南人,主任技师,主要从事临床输血工作,（Tel）15953124027。
  • 作者简介:芦璐（1971-）,女,山东济南人,主任医师,主要从事临床输血管理工作,（Tel）15806619766（E-mail）1216048988@qq.com。

Effects of Blood Transfusion Following WBC Filtration on the Immunity and Inflammatory Factors in Patients with Severe Trauma

LU Lu, GAO Yang   

  1. Department of Blood Transfusion,the Third Provincial Hospital of Shandong,Jinan,250031
  • Received:2017-11-21 Online:2019-08-20 Published:2019-08-28

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摘要： 目的 探讨白细胞过滤对严重创伤输血患者免疫功能和炎症因子的影响。方法 选择147例创伤患者分为3组,第1组49例输入不含有白细胞的成分血液,第2组49例输入全血,第3组49例未输血,测定3组输血前、输血后1 d、7 d CD3+、CD4+、CD8+、CD4+／CD8+及细胞比例血清肿瘤坏死因子（TNF）-α和白细胞介素（IL）-6水平。结果 输去白红细胞患者在输血后7 d CD3+、CD4+、CD8+、CD4+／CD8+与输血前无明显差异。输血后第7天,输去白红细胞患者的 CD3+、CD4+、CD8+、CD4+／CD8+比输全血组明显升高（P<0.05）。3组患者在输血后1 d血清TNF-α和IL-6比输血前明显升高（P<0.01）,输血后7 d逐渐下降。输血后第7天,第1组患者血清TNF-α和IL-6均高于输血前（P<0.01,P<0.05）。第2组患者血清TNF-α仍高于输血前（P<0.05）,血清IL-6与输血前的差异无统计学意义（P>0.05）。第1组输血后7 d血清TNF-α和IL-6均高于第2组和第3组（P<0.05）。结论 滤过白细胞的输血可以明显延缓血清TNF-α和IL-6的下降,对输血后患者的康复有重要意义。

关键词: 输血, 白细胞过滤, 免疫功能, 炎症因子

Abstract: Objective To study the immune function and inflammatory factors after the blood transfusions following leukocyte filtration in the patients with severe trauma. Methods One hundred and forty-seven patients were randomLy divided into three groups,49 patients of the first group received transfusions with white blood cells removed and 49 patients of second group were given conventional plasma products with white blood cells. The patients in the third group untreated with transfusion were taken as control. Concentrations of CD3+,CD4+,CD8+,CD4+/CD8+,TNF-α,and IL-6 were determined in all of the subjects investigated before and after transfusion on 1d and 7d . Results No difference was noted of CD3+,CD4+,CD8+,and CD4+／CD8+ in those who received WBC-removed blood transfusion（P>0.05）on day 7 while the indicators obviously decreased in those with whole blood transfusions（P<0.05）. All the patients with transfusion showed a significant increase in serum TNF-αand IL-6 （P<0.01）on 1d and gradually decreased on 7d after transfusion（P<0.01）. The level of TNF-αand IL-6 was elevated in the patients with WBC- removed transfusion on 7d after transfusion（P<0.01）.The patients of second group presented an increased level of TNF-αafter transfusion（P<0.05）but no change was seen for IL-6（P>0.05）. Conclusion Leukocytes-free transfusion may delay the decrease of serum TNF-αand IL-6,which is helpful for rehabilitation of the patients with blood transfusion.

Key words: Blood transfusion, Leukocyte filtration, Immune indicators, Inflammatory factors

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