RhC抗原在输血后24小时对受血者免疫功能的影响

发布时间：2018-01-20 00:02

  本文关键词： 输血 RhC抗原 同型输血 免疫 细胞因子　出处：《吉林大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的： 检测RhC抗原阴性患者输注RhC抗原阳性血液前、后IL-2、IL-4、CD3+、CD4+、CD8+的变化，探讨RhC抗原对受血者免疫功能产生的影响。 方法： 在2013年6月-2014年12月的吉林大学第一医院急诊手术入院、年龄在21~40岁之间，ABO、RhD同型输血2U的622例患者输血前的静脉血样本中，应用微柱凝胶法和盐水介质法两种方法检测RhC抗原，从中选取RhC抗原阴性样本60份作为受血者样本。同期在长春市中心血站供应的献血者标本中，应用微柱凝胶法和盐水介质法两种方法检测RhC抗原，从中选取RhC抗原阴性样本30份、RhC抗原阳性样本30份作为献血者标本。研究分两组：一组为RhC抗原异型输血组30例，为Rh系统C抗原阴性受血者输注RhC抗原阳性献血者血液，二者为RhC抗原异型输注。另一组为RhC抗原同型输血组30例，为RhC抗原阴性受血者输注Rh C抗原阴性献血者血液，二者为RhC抗原同型输注。收集RhC抗原异型输血组和RhC抗原同型输血组受血者输血前和输血后24小时的静脉血，应用ELISA法测定IL-2、IL-4的变化，应用流式细胞术检测CD3+、CD4+、CD8+细胞。经统计学处理，分析以上免疫指标的变化，讨论RhC抗原阴性受血者输注RhC抗原阳性血液后的免疫状态。 结果： 1. RhC抗原异型输血组输血后24小时检测标本，IL-2值下降，平均下降10pg/m1，IL-4平均升高8pg/m1，与输血前相比P0.05，二者有显著性差异。RhC抗原同型输血组输血后24小时检测标本，IL-2平均下降1pg/m1，IL-4平均升高1pg/m1，与输血前相比P0.05，二者差异无统计学意义。 2. RhC抗原异型输血组检测输血后24小时静脉标本，CD3+平均下降比例为13、CD4+下降比例为6、CD8+下降比例为3，与输血前相比P0.05，二者有显著性差异。RhC抗原同型输血组检测输血后24小时静脉标本，CD3+平均下降比例为3、CD4+下降比例为3、CD8+下降比例为2，与输血前相比P0.05，二者差异无统计学意义。 3.在60例RhC阴性受血者中RhC抗原异型输血30例和RhC抗原同型输血组30例，患者输血后均未发生输血反应。 结论： 1. RhC抗原异型输血组输血后24小时，IL-2下降，IL-4升高，表明受血者的免疫功能受到抑制。 2. RhC抗原异型输血组输血后24小时，CD3+、CD4+、CD8+下降，表明受血者的免疫功能受到抑制。 3. RhC抗原异型输血组可能因RhC抗原异型输注，，理论上使其T细胞受体产生记忆细胞，可能会在一次输血后产生RhC抗体，使受血者在二次输血时发生输血反应。
[Abstract]:Objective: Before and after transfusion of RhC antigen positive blood in patients with negative RhC antigen, the changes of CD4 / CD8 of IL-4 + CD3 + CD3 were detected. To investigate the effect of RhC antigen on immune function of recipients. Methods: From June 2013 to December 2014, the first Hospital of Jilin University was admitted to hospital for emergency operation, aged between 21 and 40 years. Microcolumn gel method and saline medium method were used to detect RhC antigen in the venous blood samples of 622 patients with 2U RhD homologous transfusion before blood transfusion. 60 negative samples of RhC antigen were selected as recipient samples. In the same period, microcolumn gel method and saline medium method were used to detect RhC antigen in blood donors supplied by Changchun central blood station. Thirty samples of RhC antigen negative were selected as blood donors. The study was divided into two groups: one group was 30 cases of RhC antigen abnormal transfusion group. The patients with Rh system C antigen negative recipient received RhC antigen positive blood transfusion, both of them were RhC antigen abnormal transfusion, the other group was RhC antigen homotype transfusion group (30 cases). RhC antigen negative recipients were infused with RhC antigen negative blood donors. The venous blood samples were collected before and 24 hours after the transfusion of RhC antigen and RhC antigen homotypic transfusion group, and the IL-2 was determined by ELISA method. The changes of IL-4 were detected by flow cytometry. The changes of the above immunological indexes were analyzed by statistical analysis. The immune status of patients with negative RhC antigen after transfusion of RhC antigen positive blood was discussed. Results: 1. After 24 hours of blood transfusion, the IL-2 value of RhC antigen abnormal transfusion group was decreased, and the average decrease of IL-4 was 10 PG / m ~ (-1) and the increase of IL-4 was 8 PG / m ~ (1). Compared with P0.05 before transfusion, there was a significant difference between the two groups. The IL-2 decreased by 1 PG / m 1 24 hours after transfusion in RhC antigen homotype transfusion group. IL-4 increased by 1 PG / m ~ (-1) on average, compared with that before blood transfusion (P 0.05), there was no significant difference between the two groups. 2.The average decrease of CD3 in RhC antigen-allogeneic transfusion group 24 hours after blood transfusion was 13% CD4 and 6% CD8 decreased 3. Compared with P0.05 before transfusion, there was a significant difference between the two groups. In RhC antigen homotype blood transfusion group, the average percentage of CD3 in venous specimens 24 hours after blood transfusion was 3%. The decrease of CD8 was 2%, compared with that before blood transfusion (P 0.05), there was no significant difference between the two groups. 3. In 60 cases of RhC negative recipients, 30 cases of RhC antigen abnormal transfusion and 30 cases of RhC antigen homotypic transfusion group had no blood transfusion reaction after transfusion. Conclusion: 1. In RhC antigenic transfusion group, IL-2 decreased and IL-4 increased 24 hours after transfusion, indicating that the immune function of the recipients was inhibited. 2. The CD3 CD 4 and CD 8 8 decreased 24 hours after transfusion in RhC antigen-allogeneic transfusion group, indicating that the immune function of the recipients was inhibited. 3. The RhC antigen abnormal transfusion group may cause the T cell receptor to produce memory cells in theory, and may produce RhC antibody after a single transfusion. To cause the recipient to undergo a blood transfusion reaction during a second transfusion.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R446.6

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