低氧血症对老年肝硬化患者红细胞免疫功能影响.docVIP

低氧血症对老年肝硬化患者红细胞免疫功能影响 　　　作者；吴炎，孙瑜，林木贤，高燕，康文全 ［摘要］ 目的 探讨低氧血症对老年肝硬化患者红细胞免疫功能的影响。方法 采用红细胞酵母菌混合花环法检测了68例肝硬化患者（其中≥60岁组24例，lt;60岁组44例）红细胞C3b受体花环率（RBCC3bRR）和红细胞免疫复合物花环率（RBCICR）；同时测定两组的动脉血氧分压（PaO2）水平。结果 老年组低氧血症发生率为70.8%，非老年组为63.6%，两组差异无显著性（P＞0.05）。但在老年肝硬化组RBCC3bRR明显降低（Plt;0.01），而两组RBCICR则差异无显著性（P＞0.05）；在老年组及非老年组，肝性脑病（HE）的发生率分别为54.1%和20.5%，感染发生率分别为58.3% 和22.7%，差异有显著性（均Plt;0.05）。结论 老年肝硬化患者红细胞免疫功能明显低下，尤其在动脉低氧血症时可以加重老年人红细胞C3b受体的损害。且老年肝硬化病人更易并发HE，也更易并发感染。 ［关键词］ 肝硬化；低氧血症；红细胞免疫功能；老年人 Relationship between hypoxaemia and red cell immune function in elderly patients with liver cirrhosis ［Abstract］ Objective To evaluate the relationship between hypoxaemia and red cell immune function in elderly patients with liver cirrhosis.Methods Of the 68 patients with liver cirrhosis，24 cases of elderly patients (≥60 years)，and 44 cases of non elderly patients (lt;60 years).The erythrocyte C3b receptor rosette (RBCC3bRR)，immune complex rosette (RBCICR) were tested by red cell yeast mixture rose，and arterial bloodgas assay were determined in both groups.Results The incidence of hypoxaemia in the elderly patients was 70.8%，and in the non elderly patients was 63.6%（P＞0.05）.The levels of RBCC3bRR was significantly decreased in elderly patients（Plt;0.05），RBCICR was not different from both groups.In the group of elderly patients and non elderly patients，hepatic encephalopathy (HE) was 54.1% and 20.5%（Plt;0.05）.The incidence of infection was 58.3% and 22.7%（Plt;0.05）.Conclusion Erythrocyte immune function were significantly decreased in elderly patients with liver cirrhosis，particularly in arterial hypoxaemia，might contribute to the decrease of erythrocyte C3b receptor in elderly patients.elderly patients were easy to accompanied by HE and infection. ［Key words］ cirrhosis;hypoxaemia;red cell immune function;elderly 免疫是人体的一种生物学功能，它的任务是特异地或非特异性地识别和排斥、清除一切异物或抗原性物质。红细胞具有吸附、运输免疫复合物、递呈抗原和促进吞噬等多种免疫功能，红细胞C3b受体是其发挥作用的关键部位。RBCC3bRR能较敏感地反映红细胞免疫黏附能力［1］。肝硬化患者红细胞免疫功能受损的观点已被反复证实［2］。本文旨在分析动脉低氧血症时对