Effects Of Hydroxyethyl Starch Infusion On Postoperative Changes In Immunity Of T-lymphocyte In Gastric Cancer Patients Undergoing Surgery

Objective: The aim of this study was to observe the effects of hydroxyethyl starch (HAES 200/0.5) infusion on postoperative changes in T-lymphocyte subsets and TH1/TH2 related cytokine in patients with gastric cancer radical surgery. Methods: Thirty ASA I-II patients undergoing elective radical operation for gastric cancer, were randomly allocated into two groups: H group and B group. They were received 1000ml of HAES(n= 15) or 400ml of allogeneic whole blood (n=15) during operation respectively. Patients with endocrine, immunological, liver or kidney disease and those who had received radio- or chemotherapy were excluded. No cortical hormone was used during perioperative period, the same anesthetic drugs, techniques and postoperative analgesia were taken, trying to avoid their effects on immunclogical function, and no patient received allogenic blood transfusion after operation. Blood samples were taken from peripheral vein before induction and on the 3rd, 7th day after operation for determination of T-lymphocyte subsets CD3+> CD/and CD4+/CDg+ values by flow cytometer. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of IL-2,IL-10, EL-12 and v -IFN in serum. Results: (1) The two groups were comparable regard to age, body weight, surgicalduration, intraoperative blood loss and the baselines of T-lymphocyte subsets and cytokine (p>0.05). (2) In B group, CD3\ CD/ and CD4~/CD8" decreased significantly after operation (P<0.05orO.01), and remained low on 7th postoperative day. The counts of them much less than those hi H group (P < 0.05). The levels of IL-2, Y-IFN and IL-12 decreased significantly after operation (p<0.05or0.01), and there was a increase of IL-10 (p<0.05). That is, there were disregulation in the function of CD//CDg+and Tm/T^, with expansion in CD/ and TH2 cells and malfunction in CD/ and TH1 cells. (3) In H group, CD3~\ CD/ decreased significantly on the 3rd postoperative day (p<0.05), but they almost returned to baseline values on the 7th day after operation. Moreover, CD8~\ CD//CD/ and cytokines remained unchanged markedly after operation (p>0.05). As compared with B group, the concentrations of IL-2 and Y-IFN were higher than those (p<0.05).Conclusions: There is a serious and prolonged inhibition of cellular immunity in patients received blood transfusion during operation. Hydroxyethyl starch does not affect the immunity of T-lymphocyte in postoperative period. HAES is a reasonable plasma substitute for cancer patients with compromised immune function.