人工全髋关节置换对红细胞免疫功能影响临床探究.docVIP

人工全髋关节置换对红细胞免疫功能影响临床探究 　 作者：喻德富，王友华，姜胜华，刘璠 【摘要】 目的：探讨人工全髋关节置换术对红细胞免疫功能的影响。方法：人工全髋关节置换患者32例以郭峰法测不同时间点红细胞Ⅰ型补体受体花环率(RC3bRR )、红细胞免疫复合物花环率( RICR )、自然肿瘤红细胞花环率(NTERR)，同时测20例健康人红细胞免疫上述指标作为对照。结果：手术开始30、60min，术后l0min、1天RC3bRR、NTERR、RICR与对照组比较差异有统计学意义(Plt;0.05 )；手术开始30、60min，术后l0min时RC3bRR、NTERR低于术前及术后1天(Plt;0.05 ), RICR高于术前及术后1天(Plt;0.05 )。结论：人工全髋关节置换术后红细胞免疫功能降低，清除循环免疫复合物能力下降，可能是术后深静脉血栓形成的原因之一。 【关键词】 红细胞；免疫功能；髋关节置换术 [Abstract] Objective:To study the change of RBC immune after total hip replacement. Methods:32 cases of total hip replacement were studied by measuring different time of the red blood cell C3b receptor erythrocyte rate (RC3bRR) , immune complex rate (RICR) and natural tumour erythrocyte rosette rate (NTERR) with Guo Feng methods. In the mean time, the same immune data of 20 healthy old people were measured to be compared with. Results: At 30 min and 60 min in operation, 10 min after operation and 1 day after operation, RC3bRR and NTERR were obviously lower than those of contrasting group, RICR was obviously higher than that of contrasting group(Plt;0.05).At 30 min and 60 min in operation and 10 min after operation, RC3bRR and NTERR were obviously lower than those in 1 day before operation and 1 day after operation(Plt;0.05), RICR was higher than that in 1 day before operation and 1 day after operation(Plt;0.05).RC3bRR, RICR and NTERR in 1 day before operation were different from those in 1 day after operation, but there was notable difference between them (Pgt;0.05). Conclusions:The immune function of RBC reduces after total hip replacement, and then ability of eliminating the circulating immune compound comes down. This may be one reason in developing deep vein thrombosis after total hip replacement. [Key words] Red blood cell; Immune function; Total hip replacement 　　人工全髋关节置换（THR）患者术后易发生下肢深静脉血栓形成，发生率为13.3％[1，2]少数可造成肺栓塞导致死亡[3]。近年来研究表明，手术创伤、应激和麻醉可使红细胞生物学行为发生变化，这些损伤变形及免疫功能低下的红细胞是血栓形成的主要触发因素之一[4]。本研究旨在探讨人工全髋关节置换术对红细胞免疫功能的影响。 1 资料与方法 1.1 一般资料 2005年10月～2006年10月因