法洛四联症患者手术治疗期间免疫状态的特点。

Igor V. Dudarev
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摘要

本文对26例1 ~ 3岁的法洛四联症患者进行了检查。所有检查的患者都需要手术矫正心脏缺陷,并在人工循环条件下进行手术。所有患者均处于相对代偿或亚代偿状态。法洛四联症患者外周血饱和SaO(2)水平为66.27 +/- 7.2%。目的是研究法洛四联症患者术后免疫参数的动态变化。为了解决这一问题,开展了免疫状态的复杂动态研究。采用流式细胞荧光法鉴定外周血免疫活性细胞的膜标志物,使用抗原单克隆抗体:CD3、CD4、CD5、CD8、CD11b、CD16、CD22、CD25、CD45 RA、HLA DR、CD95。分别于术前、术后第7天、第30天、术后3个月动态测定各项参数。法洛四联症患者的免疫状态参数在术后得到稳定,并维持在3个月内。显然,这可能是由于心脏动力学的正常化,因此代谢过程的稳定,毫无疑问,呈现对儿童免疫系统的调节作用。然而,免疫活性细胞的功能活性仍然失效是使用免疫校正治疗的原因,目的是更快地稳定免疫失衡。
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Features of Immune Status in Patients with Tetralogy of Fallot during Operative Treatment.

Twenty six patients with tetralogy of Fallot at the age from 1 to 3 years old were examined. All examined patients required surgical correction of heart defect and were operated under conditions of artificial circulation. All patients were in a status of relative compensation or subcompensation. The level of a saturation SaO(2) among patients with tetralogy of Fallot in peripheral arterial blood was equal to 66.27 +/- 7.2%. The purpose of work was to study the dynamics of immunological parameters in patients with tetralogy of Fallot in the postoperative period. The complex dynamic study of immune status was carried out to resolve such a task. Identification of membrane markers of peripheral blood immunocompetent cells was made by flow cytofluometry with the usage of monoclonal antibodies to antigens: CD3, CD4, CD5, CD8, CD11b, CD16, CD22, CD25, CD45 RA, HLA DR, CD95. The parameters were determined in dynamics: before operation, on the 7th, the 30th day and after 3 months after operation. Stabilization of parameters of the immune status among patients with tetralogy of Fallot, has been found in the postoperative period and was maintained within 3 months. Apparently it may be due to normalization of cardiohemodynamics, and as a consequence the stabilization of metabolic processes, undoubtedly, rendering modulating effects on immune system of children. However remaining failure of functional activity of immunocompetent cells is the reason to the usage of immunocorrection therapy with the purpose of faster stabilization of immune disbalance.

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