Gessler Peter, Pfenninger Juerg, Pfammatter Jean-Pierre, Carrel Thierry, Dahinden Clemens
Department of Pediatric Intensive Care & Neonatology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
Intensive Care Med. 2002 Dec;28(12):1786-91. doi: 10.1007/s00134-002-1525-x. Epub 2002 Oct 17.
To determine whether the activation state of polymorphonuclear neutrophils (PMNs) and monocytes contributes to the inflammatory response after cardiopulmonary bypass (CPB) in pediatric cardiac surgery.
Observational prospective clinical study.
Pediatric intensive care unit of a university hospital.
Twenty pediatric patients before and after open heart surgery with CPB.
Cell counts of circulating PMNs and monocytes as well as phenotypic and functional analysis of these cells, and plasma levels of myeloperoxidase.
Levels of myeloperoxidase (a marker of PMN degranulation) were significantly elevated after CPB (2.9+/-1.6 ng/ml before CPB versus 13.7+/-6.5 ng/ml after CPB, p=0.0001). However, PMN function, as measured by surface expression of CD11b/CD18 and phagocytic respiratory burst, was reduced. In contrast, the phagocytic respiratory burst of circulating monocytes was increased in some patients and there was a correlation with the increase of monocyte cell count after CPB (r=0.63, p=0.015).
After the end of CPB, there was an ongoing inflammatory process. In particular, there was an activation of monocytes after the end of CPB.
确定多形核中性粒细胞（PMNs）和单核细胞的激活状态是否有助于小儿心脏手术体外循环（CPB）后的炎症反应。
观察性前瞻性临床研究。
大学医院的儿科重症监护病房。
20例接受CPB心脏直视手术前后的小儿患者。
循环中PMNs和单核细胞的细胞计数以及这些细胞的表型和功能分析，以及血浆髓过氧化物酶水平。
CPB后髓过氧化物酶（PMN脱颗粒的标志物）水平显著升高（CPB前为2.9±1.6 ng/ml，CPB后为13.7±6.5 ng/ml，p = 0.0001）。然而，通过CD11b/CD18的表面表达和吞噬性呼吸爆发测量的PMN功能降低。相反，一些患者循环单核细胞的吞噬性呼吸爆发增加，并且与CPB后单核细胞计数的增加相关（r = 0.63，p = 0.015）。
CPB结束后，存在持续的炎症过程。特别是，CPB结束后单核细胞被激活。
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