摘要
目的观察风湿性心脏病(RHD)患者在体外循环(ECC)心脏瓣膜置换术前、后细胞免疫功能的变化。方法用流式细胞仪检测28例ECC瓣膜置换术RHD患者(RHD组,其中单瓣组15例,双瓣组13例)和20例非体外循环冠状动脉搭桥术患者(对照组)术前、术毕及术后第1、3、5、8天外周血CD3+、CD3+/CD4+、CD3+/CD8+T细胞、NK细胞(CD3-/CD16+56+)、CD3+CD4-CD8-双阴性T细胞的水平。结果 RHD组患者与术前比较,术后CD3+、CD4+、CD4+/CD8+、NK细胞计数明显降低(P<0.05),CD8+、CD3+CD4-CD8-计数明显升高(P<0.05)。双瓣组的上述指标波动明显大于单瓣组。与对照组比较,术后RHD组患者的CD3+、CD4+和CD4+/CD8+T细胞计数明显下降(P<0.05),而CD8+和CD3+CD4-CD8-计数明显升高(P<0.05)。对照组NK细胞在术前、术后无明显变化(P>0.05)。结论 ECC瓣膜置换术可使RHD患者的细胞免疫功能受到明显的抑制。
Objective To observe the changes of cellular immune function before and after heart valve replacement with extracorporeal circulation（ECC） in patients with rheumatic heart disease（RHD）.Methods Flow cytometry was employed to detect lymphocytes in 28 patients with RHD accepted heart valve replacement with ECC（RHD group including 15 in single valve group and 13 in double valve group） and 20 patients（control group） accepted off-pump coronary artery bypass grafting.Levels of CD3＋,CD3＋/CD4＋,CD3＋/CD8＋ T cells,NK cells（CD3-/CD16＋56＋） and CD3＋CD4-CD8-double negative T cells in peripheral blood before,and 1,3,5,8 days after operation were detected.Results There was no statistically significant difference among each detection indexes before operation（P0.05）.Compared with pre-operation,the counts of CD3＋,CD4＋,CD4＋/CD8＋ T cells and NK cells of patients were decreased markedly while those of CD8＋ and CD3＋CD4-CD8-increased significantly after operation in RHD group（P0.05）.Fluctuation of indexes above in double valve group was obviously greater than those in single valve group.Compared with control group,the counts of CD3＋,CD4＋ and CD4＋/CD8＋ T cells were also decreased while those of CD8＋ and CD3＋CD4-CD8-were also increased significantly in RHD group after operation（P0.05）.There was no significantly changes of NK cells between pre-operation and post-operation（P0.05）.Conclusion Heart valve replacement with ECC can exert a significant inhibition to cellular immune function of patients with RHD.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第35期3584-3586,共3页
Chongqing medicine
关键词
体外循环
心脏瓣膜假体植入
风湿性心脏病
免疫
细胞
extracorporeal circulation
heart valve prosthesis implantation
rheumatic heart disease
immunity
cellular
