西咪替丁对体外循环心内直视手术患者细胞免疫功能的调节作用

【摘要】： Objective: To sttldy tl1e damaging effects of cardiopulmonary bypass(CPB) on hllman cellu1ar immune ftlnction and the immune modulating effect ofcilnetidine. Methods: ln a prospective randomized study,20 patients were divided into two 8iroups of equal size. Cimetidine g'roup patients received 0.4g of cimetidine intravenously before bypass and 0.2g q6h intravenous inftlsion of cimetidine after the operation, continuing unti1l the fift1l postoperative day. Control-8iroup patients received convel1tional perioperative theraPy. Lymphocyte subsets, lymphocyte transformation index were measured perioperatively. Results: Postoperative reduction in the percentages of CD',. CD+#cells were observed to some deg'ree in both groups. In cimetidine grotlp,tl1ese values decressed slowly and restored qtlickly, significant reduction in CD+,was observed on postoperative days l to 3.In contrast,CD+,counts were elevated significa11tly on tl1e postoperative days l in control-Liroup. Postoperative reduction in tl1e level of CPM. PHA-SI al1d CD'./CD+,were obselved in control- gro[lp,llevertlleless,in cimetidine-group,these values restored approximately on the postoperative days 3. Conclusion: Cell-lnediated immunity is impaired after cardic operations involving CPB, cimetidine can counteracts this depressive ef1bcts and may possibly reduce postoperative susceptibility to infection.