文章摘要
谢 佳,王志云,黎 欢,吴雅娟,彭 丹.预存式自体输血与异体输血对原发性肝癌围术期患者凝血功能、炎性因子和T细胞亚群的影响[J].,2021,(24):4719-4723
预存式自体输血与异体输血对原发性肝癌围术期患者凝血功能、炎性因子和T细胞亚群的影响
Effects of Prestored Autologous Blood Transfusion and Allogeneic Blood Transfusion on Coagulation Function, Inflammatory Factors and T Cell Subsets in Perioperative Patients with Primary Liver Cancer
投稿时间:2021-04-26  修订日期:2021-05-22
DOI:10.13241/j.cnki.pmb.2021.24.024
中文关键词: 预存式自体输血  异体输血  原发性肝癌  凝血功能  炎性因子  T细胞亚群
英文关键词: Prestored autotransfusion  Allogeneic blood transfusion  Primary liver cancer  Coagulation function  Inflammatory factors  T cell subset
基金项目:四川省卫健委重点资助项目(18ZD029)
作者单位E-mail
谢 佳 中国人民解放军西部战区总医院输血科 四川 成都 610083 xiejia0602@126.com 
王志云 中国人民解放军西部战区总医院输血科 四川 成都 610083  
黎 欢 中国人民解放军西部战区总医院输血科 四川 成都 610083  
吴雅娟 中国人民解放军西部战区总医院输血科 四川 成都 610083  
彭 丹 中国人民解放军西部战区总医院输血科 四川 成都 610083  
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中文摘要:
      摘要 目的:对比异体输血和预存式自体输血对原发性肝癌围术期患者凝血功能、炎性因子和T细胞亚群的影响。方法:回顾性选取2018年8月~2020年12月期间在西部战区总医院行肝部分切除术的91例原发性肝癌患者的临床资料,根据输血方式的不同分为异体组和自体组,例数分别为44例、47例,观察两组患者凝血功能、炎性因子和T细胞亚群的变化情况,记录两组输血不良反应发生率。结果:自体组、异体组术后1 d活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、D-二聚体(D-D)、凝血酶原时间(PT)较术前升高(P<0.05),术后5 d的APTT、TT、PT、D-D均较术后1 d降低(P<0.05),且两组术后1 d、术后5 d上述指标对比无明显差异(P>0.05)。自体组术后1 d、术后5 d的白介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)低于异体组(P<0.05)。自体组术后1 d、术后5 d 的CD3+、CD4+、CD4+/CD8+高于异体组,CD8+低于异体组(P<0.05)。两组患者输血不良反应发生率比较差异无统计学意义(P>0.05)。结论:原发性肝癌围术期患者采用预存式自体输血,对机体凝血功能的影响小,同时还可减轻免疫抑制,抑制机体炎性反应,具有一定临床应用价值。
英文摘要:
      ABSTRACT Objective: To compare the effects of allogeneic blood transfusion and prestored autologous blood transfusion on coagulation function, inflammatory factors and T cell subsets in perioperative patients with primary liver cancer. Methods: Clinical data of 91 patients with primary liver cancer who underwent partial hepatectomy in the General Hospital of the Western Theater Command from August 2018 to December 2020 were retrospectively selected, and they were divided into allogeneic group and autologous group according to different blood transfusion methods. The number of cases were 44 and 47 respectively. The changes of coagulation function, inflammatory factors and T cell subsets in the two groups were observed, and the incidence of adverse transfusion reaction in the two groups was recorded. Results: The activated partial thromboplastin time (APTT), thrombin time (TT), D-Dimer (D-D) and prothrombin time (PT) in autologous group and allogeneic group at 1d after operation were higher than those before operation(P<0.05), and the APTT, TT, PT and D-D at 5 d after operation were lower than those at 1d after operation(P<0.05), there was no significant difference between the two groups at 1 d and 5 d after operation (P>0.05). Interleukin (IL)-6, IL-8 and tumor necrosis factor-α (TNF-α) at 1 d and 5 d after operation in the autologous group was lower than those in allogeneic group(P<0.05). The levels of CD3+, CD4+, CD4+/CD8+ in autologous group were higher than those in allogeneic group, and CD8+ was lower than that in allogeneic group(P<0.05). There was no significant difference in the incidence of adverse transfusion reaction between the two groups(P>0.05). Conclusion: Prestored autotransfusion in perioperative patients with primary liver cancer has little effect on the body's coagulation function, and can also relieve immunosuppression and suppress the body's inflammatory response, which has certain clinical application value.
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