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目的：探讨自体血回输对青少年特发性脊柱侧凸患者围手术期细胞免疫功能的影响。方法：2002年2月～2005年2月，根据术中输血的方式将特发性脊柱侧凸患者148例分为2组，异体输血组(Ⅰ组)42例：术中全部输异体成分血；自体血回输组(Ⅱ组)106例：术中采用血液回收机将自体血回输给患者，使患者红细胞比容(HCT)≥30％，Hb≥10g／L，如果达不到低限，适量补充异体血。观察两组异体血输入量、过敏反应发生率；并分别于入手术室、术后第1天及第5天抽取静脉血，测定T细胞亚群和NK细胞的数量。结果：Ⅰ组平均异体血输入量850±170ml，Ⅱ组中有58例除了自体血回输外补充了异体血，平均410±150ml。输血反应发生率Ⅰ组为26．2％(11／42)，Ⅱ组为4．7％(5／106)，两组间存在显著性差异(P＜0．01)。两组术后第1天CD3~+、CD4~+、CD4~+／CD8~+、NK细胞较术前显著减少(P＜0．05或P＜0．01)，异体输血组较自体输血组减少更明显(P＜0．05)。术后第5天异体输血组CD3~+、CD4~+、CD4~+／CD8~+、NK细胞仍较术前显著减少，自体输血组基本恢复正常，两组间存在显著差异(P＜0．05)。结论：自体血回输可明显减少脊柱侧凸矫形患者异体血输入量，术后自体输血患者细胞免疫功能的抑制较异体血输入者轻，术后细胞免疫功能恢复快。
Objective: To investigate the effects of autologous blood transfusion on cellular immune function in adolescent idiopathic scoliosis patients during perioperative period. Methods: From February 2002 to February 2005, 148 cases of idiopathic scoliosis were divided into two groups according to intraoperative blood transfusion, 42 cases of allogeneic transfusion group (Ⅰ group) ; Autologous blood transfusion group (group Ⅱ) 106 cases: intraoperative recovery of autologous blood using a blood collection machine to the patient, the patient hematocrit (HCT) ≥ 30%, Hb ≥ 10g / L, if not reach low Limit, appropriate amount of allogeneic blood. The incidence of allogeneic blood and the incidence of anaphylaxis in both groups were observed. Venous blood was drawn from the operating room and on the first day and the fifth day after operation respectively. The numbers of T lymphocyte subsets and NK cells were measured. Results: In group Ⅰ, the mean allogenic blood volume was 850 ± 170ml. In group Ⅱ, 58 cases were allotransplantated with allogeneic blood except autologous blood, with an average of 410 ± 150ml. The incidence of transfusion reaction was 26.2% (11/42) in group Ⅰ and 4.7% (5/106) in group Ⅱ, with significant difference between the two groups (P <0.01). The levels of CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + and NK cells in the two groups after operation were significantly lower than those before operation (P <0.05 or P <0.01) Group decreased more significantly (P <0.05). The number of CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + and NK cells in allogeneic blood transfusion group was significantly decreased on day 5 postoperatively, and the autologous blood transfusion group returned to normal with significant difference between the two groups (P <0 .05). Conclusion: Autologous blood transfusion can significantly reduce the amount of allogeneic blood input in orthopedic patients with scoliosis. The postoperative autologous blood transfusion suppressed the cellular immune function more than the allogeneic blood transfused, and the postoperative cellular immune function recovered rapidly.