Chu S H, Hu R H, Lee Y C, Chen K T
Department of Surgery, National Taiwan Uniersity Hospital, Taipei.
Thorac Cardiovasc Surg. 1995 Apr;43(2):94-8. doi: 10.1055/s-2007-1013778.
There are a lot of immunological changes after major surgery, especially in open heart surgery when blood flows through a cardiopulmonary bypass system. We monitored leukocyte count, lymphocyte subpopulation count, soluble IL- 2 receptor (sIL-2r) and serum IL-2 levels, and an immunosuppressive acidic protein (IAP) level before and on the 1st, 7th, and 14th day after open heart surgery. It was noted that there were significant increases of total leukocyte and granulocyte counts for more than two weeks. But total lymphocyte, T-lymphocyte, b-lymphocyte, natural killer cell, suppressor T-cell, and helper T-cell all showed significant decreases in absolute numbers for more than one week as compared to the preoperative values. Serum IAP level was elevated for more than two weeks after operation. Serum IL-2 decreased but serum sIL-2R increased in the postoperative period. It is concluded that there is a period of immunosuppression after open heart surgery which lasts for at least one week and perhaps more than two weeks.
大手术后会出现许多免疫变化,尤其是在心脏直视手术中,血液流经体外循环系统时。我们监测了心脏直视手术前、术后第1天、第7天和第14天的白细胞计数、淋巴细胞亚群计数、可溶性白细胞介素-2受体(sIL-2r)和血清白细胞介素-2水平,以及免疫抑制酸性蛋白(IAP)水平。结果发现,总白细胞和粒细胞计数显著增加超过两周。但与术前值相比,总淋巴细胞、T淋巴细胞、B淋巴细胞、自然杀伤细胞、抑制性T细胞和辅助性T细胞的绝对数量在一周多的时间里均显著下降。术后血清IAP水平升高超过两周。术后血清白细胞介素-2下降,但血清sIL-2R升高。结论是,心脏直视手术后存在一段免疫抑制期,至少持续一周,可能超过两周。