摘要目的 评价滤除白细胞异体血对围术期患儿细胞免疫功能的影响.方法 选择术中行异体输血的患儿359例,年龄3个月～14岁,体重5～74 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其随机分为2组:对照组(C组,n=163)术中输注未滤除白细胞的异体血；滤除白细胞异体血组(D组,n=196)术中输注滤除白细胞的异体血.分别于输血前、输血后2和6d时,采外周静脉血样,采用流式细胞仪测定CD3+、CD4+、CD8+、CD56+的水平,计算CD4+/CD8+.记录术中输血量、手术时间、术后引流时间、抗生素使用时间、住院时间和术后感染的发生情况.结果 与C组比较,D组输血后6d时CD3+、CD4+、CD4+/CD8+和CD56+的水平升高,引流时间、抗生素使用时间和住院时间缩短,术后感染发生率降低(P＜0.05).两组CD8+水平、术中输血量和手术时间差异无统计学意义(P ＞0.05).结论 输注滤除白细胞的异体血有助于改善围术期患儿的细胞免疫功能.

abstractsObjective To investigate the effects of leukocyte-depleted allogeneic blood transfusion on perioperafive cellular immunity in children.Methods Three hundred and fifty-nine ASA Ⅰ or Ⅱ children aged 3 month-14 yr,weighing 5-74 kg requiring allogeneic blood transfusion during operation were randomly divided into 2 groups:control group (group C,n =163) and leukocyte depletion group (group D,n =196).In group D allogeneic blood was filtered with a leukocyte filter before being transfused during operation.Blood samples were collected from peripheral vein before blood transfusion,and at 2 and 6 d after blood transfusion for determination of levels of CD3+,CD4+,CD8+,and CD56+ by flow cytometry.CD4+/CD8+ ratio was calculated.The volume of allogeneic blood transfused during operation,the duration of operation,postoperative drainage,antibiotics administration and hospital stay and incidence of postoperative infection were recorded.Results The levels of CD3+,CD4+,CD56+ and CD4+/CD8+ ratio were significantly increased at 6 d after blood transfusion while the duration of postoperative drainage,postoperative antibiotics administration and hospital stay and incidence of postoperative infection were significantly decreased in group D compared with group C.Conclusion Leukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.