Jensen L S, Hokland M E, Nielsen H J
Arhus Universitetshospital, Arhus Kommunehospital, kirurgisk gastroenterologisk afdeling L.
Ugeskr Laeger. 1997 Aug 18;159(34):5093-7.
The objective of the study was to investigate certain immune parameters in patients undergoing elective colorectal surgery and receiving either whole blood transfusion or leucocyte-filtrated blood. Sixty consecutive patients were randomly allocated to receive either whole blood transfusion or leucocyte-filtrated blood leucocyte when transfusion was indicated. The immune parameters were investigated on the day of surgery and on day 3, 7 and 30 postoperatively. Transfusion with whole blood was followed by a significant decrease in lymphocyte proliferation and CD4+/CD8+ ratio (p < 0.01) as well as a significant increase in soluble interleukin-2 receptor and interleukin-6 (p < 0.01). Furthermore transfusion with whole blood was accompanied by a significant increase in postoperative infectious complications (p < 0.01). Patients transfused with leucocyte-filtrated blood had only minor and passing changes in the immune parameters and developed no infectious complications, indicating that effective leucocyte filtration abolishes transfusion-associated immunosuppression.
本研究的目的是调查择期行结直肠手术并接受全血输血或白细胞滤除血的患者的某些免疫参数。连续60例患者在需要输血时被随机分配接受全血输血或白细胞滤除血。在手术当天以及术后第3天、第7天和第30天对免疫参数进行调查。全血输血后淋巴细胞增殖和CD4+/CD8+比值显著降低（p<0.01），可溶性白细胞介素-2受体和白细胞介素-6显著升高（p<0.01）。此外，全血输血还伴随着术后感染并发症的显著增加（p<0.01）。接受白细胞滤除血输血的患者免疫参数仅有轻微的短暂变化，且未发生感染并发症，这表明有效的白细胞滤除可消除输血相关的免疫抑制。
