| IntroductionIntraoperation autotransfusion means that regarding bodycavity hematocele or operative region oozing of blood as bloody origin, after being dealed by anti-coagulated, filtrated , resorpted, then refused to patients . because it overcomes many defects from foreign body transfusion. Thus it is extensively used in surgery fields. Although with so many advantages , it still do harm to erythrocyte more or less, which has been verified by many reports. While, as a blood cell in blood, erythrocyte is most volume, not only it has such respiratory function as carrying oxygen and transport carbon dioxide, but also it involves in irnmunolog-ic function. It has a lot of materials related to immunity, like complement receptor Itype in cell membrane, which take part in identifying ,adherencing, con-densening antiogen, accelerating to delete immune complexes (IC ). Meanwhile superoxide dismutase (SOD) and CAT aboud in intracellular, which can clear oxygen free radical, which proke its special and nonspecial immune function and involves body immune modulation, immune balance and depletes antiogen - antibody complexes ( Ag - Ab - IC ). So it has the says of erythrocyte immune systems. So, doing well the work of protecting recollected erythrocyte from destroy means improving quality mass of recollected erythrocytes, It has been reported that medicine had protective function on red blood cell, for example, after car-diopulmonary bypass ( CPB) L - arg protect erythrocyte and Chinese medicine such as tetramethlpyrazin et al. We used Ligustrazine injection fluid on patients who undergo autotransfusion and investigate the changes of erythrocyte and how to act on it during autotransfusion.Methods( 1 ) Experimental Materials1. Instrument; microscope, refrigerator, centrifuge, erythrocyteautocounter, constant temperature bathoven.2. medicine and reagents :tetramethlpyrazine(Qiqihaer) , complement sensitized and non -sensitized zymosan freeze -dried reagents (Shanghai)(2) Patient Selection: Selecting fourty - eight patients undergoing auto-transfusionthey are randomly divided into two groups ;TMP experimental group and control group, respectively twent - four cases. Preoperation, both group in age, ASA grading and premedicine and abnormal diseases history related with rheumatism and immunity, etal, have no significant difference. The experimental group received 80 mg TMP, by adding it to viecles and in washing fluid were added TMP with the end concentration of 5% ; while the control group without any medicine.( 3 ) Collection of specimen and test: Venous blood samples ( heparin anti-coagulation ) from each of the 48 patients were obtained before operation and before autotransfution of the same patients. Respectively, centrifuged (2000rpm/ min,3 -5min)., serum is ready by erythrocyte accounter,erythfocyte is disposi-tionedl.25 x 10 /ml suspension, (designed by kuofeng) using erythrocyte yeast roster . tested the rate of red blood cell - C3b receptor rossetter ( RBC -C3bRR%) and red blood cell immune complex rosetter(RBC - ICR%). The methods: taking two test - tube, in both tubes, pretest erythrocyte suspension is added 50ul, in the first tube still serum 50 ul and zymosan free - dried reagents 50ul. In the second tube, only added zymosan freeze - dried reagents 50ul; put in constant temperature bath oven with 37. After 30 min, fully mixed and still added 0.25% 25ul; shaking uniform mixing;taking 1/3 quantity level sliding, blowing dry, methanol fixation, Wrights stain, count under light - microscope.( 4)Results;one red blood cell combined by two or more yeast meaned one rossetter, count 200 erythrocytes and calculate0 Erythrocyte morphy-.under three central fields of high light - microscope, count the number of erythrocyte deform,destroy.( 5 ) Statistical analysis: The method ofstatistic for this research used is SPSS11.5 statistic software. Date were expressed as mean sd; statistical compa-rision between group with two solely sample t - test, and comparision in the group were performed with paired t - test; A level of p <0. 05 was considered statistically significant.ResultsThere was no significant difference between two group before operation; after operation, the rate of RBC - C3bRR with TMP group were remarkably higher than that of control group;while the rate of RBC - ICR significantly decrease; in contrast to preoperation, the experimental group erythrocyte immunologic function enhance, while that of control group decrease0 meanwhile experimental group in postoperation erythrocyte morphology integrated, remain biconcave discs, almost any deformed erythrocyte. while control group had more or less spherecyte and thyony deformation. In a word, both morphology and immunologic function experimental group are all superior to control group; as well as to preoperation.DiscussionRed blood cell not only has breath function, but also has immunologic function; which is emphasized day after day recently. Erythrocyte not only by CR, receptor (it means I type complement receptor) , which excist in erythrocyte membrane with communologic adherent activities achieve his recognizion ? prey and delivery immune complexes (IC ) ; but also , he take part in living organism body nonspecific and specific immumne response and regulation 0 It is well known, hematometachysis may cause patients immune function even directly affect patients recovery of post - operation 0 If has auto - transfusion this condition, and how is his mechanism? Until to now, none is profoundly studiedo It was reported that;althoug auto -transfusion as a protective method,he may inju-ry erythcrocyte by different degrees alsoo Because erythrocyte was machanic squeezed centifugated by resorptioner, its structure and function change deform-ability decrease, some of them even ruptureN hemolysis, release hemoglobin (Hb) , cause free hemoglobin rise in plasma 0 It is believed in some reports that Hb can reach 0.4 -7. Og/L, about 1/4 patients with Hb urine0 We also verify about this that:control group pre - transfusion ,the rate of erythrocyte C3b receptor ( RBC - C3bRR% ) decline ( p < 0. 05 ) in contrast to pre - operation0 While the rate of erythrocyte immunologic complex ( RBC - ICR% ) increase ( p < 0.01) , meanwhile, erythrocyte paramorphia existing in erythrocyte increase, e-rythrocyte rupture riseo This suggest erythrocyte injured in different degree o Its immune function decrease 0 The factors causing erythrocyte immunologic function decline may be such as: auto - transfusion destroy the membrane of erythrocyte, its deformibility,attenuation and [Ca]2 + overload,all of above make CR, receptor related to immunologic function by clastely distributing in membrane decrease in number and in activity, protein with the function of membrane stability losso So it lose normal biconcave discs and member itself fluxiolity decline 0 In addition, during recollecting and transfusion, erythrocyte contact nonendothelium surface of vessel wall and degenerative protein , oxide free radical(ORF). Act it in plasma, membrane lipoid structure chang, and [ Ca ] 2 + channel open which make [ Ca ] + ion overload, ATP enzyme metabolism disturbance, Na - H2 0 retention in cell and erythrocyte tumefaction, receptor in member was destroyed and lost, superoxide dismutase( SOD) activity decline,cant clear lots of free radical, antioxide ability decrease, membrane lipoid overoxide, lose his elasticity , fragility increase.Iigustrazine as a Chinese medicine because of his cheap and easily syn-thesed is used extensively in blood activity and it also new -type[Ca]2+ antia-gent, protect [ Ca ] + overload in cell to achieve membrane stable. So protect I type complement receptor numbers and structure existing in membrane o Also it clear OFR to achieve antioxide effect. So avoid Ca2+ ,Mg2+ -ATP and Na+ ,K + -ATP enzyme inactivation. And avoid [Ca]2+ overload in cell. Thirdly, lingus-trazine as alkaloid with negative electron, absorpting the surface of vessel wall to avoid destroy of erythrocyte o hencei Iigustrazine may immune regulation to e-... |
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