Hori Yoshiyuki, Ibuki Takae, Hosokawa Toyoshi, Tanaka Yoshifumi
Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan.
J Clin Anesth. 2003 Feb;15(1):1-8. doi: 10.1016/s0952-8180(02)00455-5.
To observe changes in the peripheral lymphocyte subpopulations as an index of cellular immunity during neurosurgical procedures.
Clinical study.
Operating room of a university hospital.
11 patients with early intracranial disease who were scheduled to undergo elective neurosurgery with general anesthesia. Patients in the control group (n = 10) underwent minor surgeries such as ophthalmologic, otorhinolaryngological, or orthopedic surgeries.
Blood was sampled before anesthesia induction (t0) for baseline and at 1 hour (t(1)) and 2 hours (t(2)) following surgical incision.
Detection and quantification of lymphocyte subpopulations were performed at each time point using single-label and double-label analyses of monoclonal antibodies against lymphocyte membrane surface markers.
Significant changes in patients who underwent a neurosurgical procedure included: the percentage of total T cells (CD3+) from 57.54 +/- 3.50% at t(0) to 51.41 +/- 4.26% at t(1) and 46.29 +/- 4.02% at t(2); the percentage of inducer T cells (CD4+, Leu8+) from 27.39 +/- 2.26% at t(0), to 23.26 +/- 2.30% at t(1) and 20.82 +/- 2.70% at t(2); the CD4/CD8 ratio, from 1.78 +/- 0.25% at t(0) to 1.35 +/- 0.12% at t(1) and 1.22 +/- 0.17% at t(2). The percentage of suppressor T cells (CD8+, Leu15+) increased significantly from 10.8 +/- 1.07% at t(0) to 13.64 +/- 1.62% at t(1), and 14.82 +/- 1.24% at t(2). The percentages of the natural killer cell subsets also increased significantly. Control group patients who underwent minor surgeries showed no significant changes.
Neurosurgery-induced significant suppression of cellular immunity was demonstrated in peripheral lymphocyte subpopulations, probably from the surgical stress on the central nervous system.
观察神经外科手术过程中作为细胞免疫指标的外周淋巴细胞亚群的变化。
临床研究。
一所大学医院的手术室。
11例早期颅内疾病患者，计划接受全身麻醉下的择期神经外科手术。对照组（n = 10）患者接受眼科、耳鼻喉科或骨科等小手术。
在麻醉诱导前（t0）采集血液作为基线样本，并在手术切口后1小时（t(1)）和2小时（t(2)）采集样本。
使用针对淋巴细胞膜表面标志物的单克隆抗体进行单标记和双标记分析，在每个时间点检测和定量淋巴细胞亚群。
接受神经外科手术的患者出现显著变化，包括：总T细胞（CD3+）百分比从t(0)时的57.54±3.50%降至t(1)时的51.41±4.26%和t(2)时 的46.29±4.02%；诱导性T细胞（CD4+，Leu8+）百分比从t(0)时的27.39±2.26%降至t(1)时的23.26±2.30%和t(2)时的20.82±2.70%；CD4/CD8比值从t(0)时的1.78±0.25%降至t(1)时的1.35±0.12%和t(2)时的1.22±0.17%。抑制性T细胞（CD8+，Leu15+）百分比从t(0)时的10.8±1.07%显著增加至t(1)时的13.64±1.62%和t(2)时的14.82±1.24%。自然杀伤细胞亚群的百分比也显著增加。接受小手术的对照组患者未出现显著变化。
神经外科手术在外周淋巴细胞亚群中导致细胞免疫显著抑制，可能源于中枢神经系统的手术应激。
