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目的探讨自体输血胃癌根治术病人围术期血清新喋呤、白细胞介素-2(IL-2)浓度的变化。方法拟行胃癌根治术病人60例,随机分为2组:异体输血组(H组)术中输异体全血400 ml;自体输血组(A组)麻醉诱导后采集自体血400ml,同时输入琥珀酰明胶500ml,术中将采集的自体血进行回输。分别于麻醉诱导前(术前)、术毕拔管后(术毕)、术后第5天抽取静脉血,用ELISA法检测血清新喋呤和IL-2浓度。结果与术前比较,H组术毕和术后第5天时血清新喋呤、IL-2浓度降低,A 组术毕血清新喋呤浓度降低(P<0.05或0.01),术后第5天时恢复至术前水平,IL-2浓度无明显变化(P>0.05)。与H组比较,A组术毕和术后第5天时血清新喋呤浓度升高,IL-2浓度术后第5天时升高(P<0.01)。H组和A组新喋呤和IL-2浓度的相关系数分别为0.071和-0.29(P>0.05)。结论自体输血对胃癌根治术病人术后机体细胞免疫功能抑制较轻,与IL-2相比,血清新喋呤可更敏感的反映病人术后免疫功能。
Objective To investigate the changes of perioperative serum neopterin and interleukin-2 (IL-2) in patients with autologous blood transfusion for gastric cancer undergoing radical operation. Methods 60 patients with radical gastrectomy were randomly divided into 2 groups: Allogeneic transfusion group (H group) transfusion of whole blood 400 ml; autologous transfusion group (A group) after induction of autologous blood collected 400ml, while input amber Acyl gelatin 500ml, intraoperative autologous blood collected for reinfusion. Venous blood samples were collected before anesthesia induction (preoperative) and extubation (at the end of surgery), and serum concentrations of neopterin and IL-2 were detected by ELISA. Results Compared with those before operation, serum neopterin and IL-2 levels decreased at the end of group H and the fifth day after operation. Serum neopterin concentration decreased in group A (P <0.05 or 0.01) Before returning to the preoperative level, IL-2 concentration had no significant change (P> 0.05). Compared with group H, serum neopterin concentration increased at the end of group A and the fifth day after operation, while the concentration of IL-2 increased on the fifth day after operation (P <0.01). The correlation coefficients of neopterin and IL-2 concentrations in group H and group A were 0.071 and -0.29, respectively (P> 0.05). Conclusion Autologous blood transfusion suppresses the cellular immune function of patients after radical operation of gastric cancer. Compared with IL-2, serum neopterin can reflect the postoperative immune function more sensitively.