本文關(guān)鍵詞： 輸血 RhC抗原 同型輸血 免疫 細胞因子　出處：《吉林大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的： 檢測RhC抗原陰性患者輸注RhC抗原陽性血液前、后IL-2、IL-4、CD3+、CD4+、CD8+的變化，探討RhC抗原對受血者免疫功能產(chǎn)生的影響。 方法： 在2013年6月-2014年12月的吉林大學第一醫(yī)院急診手術(shù)入院、年齡在21~40歲之間，ABO、RhD同型輸血2U的622例患者輸血前的靜脈血樣本中，應用微柱凝膠法和鹽水介質(zhì)法兩種方法檢測RhC抗原，從中選取RhC抗原陰性樣本60份作為受血者樣本。同期在長春市中心血站供應的獻血者標本中，應用微柱凝膠法和鹽水介質(zhì)法兩種方法檢測RhC抗原，從中選取RhC抗原陰性樣本30份、RhC抗原陽性樣本30份作為獻血者標本。研究分兩組：一組為RhC抗原異型輸血組30例，為Rh系統(tǒng)C抗原陰性受血者輸注RhC抗原陽性獻血者血液，二者為RhC抗原異型輸注。另一組為RhC抗原同型輸血組30例，為RhC抗原陰性受血者輸注Rh C抗原陰性獻血者血液，二者為RhC抗原同型輸注。收集RhC抗原異型輸血組和RhC抗原同型輸血組受血者輸血前和輸血后24小時的靜脈血，應用ELISA法測定IL-2、IL-4的變化，應用流式細胞術(shù)檢測CD3+、CD4+、CD8+細胞。經(jīng)統(tǒng)計學處理，分析以上免疫指標的變化，討論RhC抗原陰性受血者輸注RhC抗原陽性血液后的免疫狀態(tài)。 結(jié)果： 1. RhC抗原異型輸血組輸血后24小時檢測標本，IL-2值下降，平均下降10pg/m1，IL-4平均升高8pg/m1，與輸血前相比P0.05，二者有顯著性差異。RhC抗原同型輸血組輸血后24小時檢測標本，IL-2平均下降1pg/m1，IL-4平均升高1pg/m1，與輸血前相比P0.05，二者差異無統(tǒng)計學意義。 2. RhC抗原異型輸血組檢測輸血后24小時靜脈標本，CD3+平均下降比例為13、CD4+下降比例為6、CD8+下降比例為3，與輸血前相比P0.05，二者有顯著性差異。RhC抗原同型輸血組檢測輸血后24小時靜脈標本，CD3+平均下降比例為3、CD4+下降比例為3、CD8+下降比例為2，與輸血前相比P0.05，二者差異無統(tǒng)計學意義。 3.在60例RhC陰性受血者中RhC抗原異型輸血30例和RhC抗原同型輸血組30例，患者輸血后均未發(fā)生輸血反應。 結(jié)論： 1. RhC抗原異型輸血組輸血后24小時，IL-2下降，IL-4升高，表明受血者的免疫功能受到抑制。 2. RhC抗原異型輸血組輸血后24小時，CD3+、CD4+、CD8+下降，表明受血者的免疫功能受到抑制。 3. RhC抗原異型輸血組可能因RhC抗原異型輸注，，理論上使其T細胞受體產(chǎn)生記憶細胞，可能會在一次輸血后產(chǎn)生RhC抗體，使受血者在二次輸血時發(fā)生輸血反應。
[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.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R446.6

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