Nakazawa S
Second Department of Surgery, Niigata University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Jul;40(7):1078-84.
This study was designed to demonstrate the effect of prostaglandin E1 (PGE1) on neutrophil activation in open heart surgery. Twenty adult patients undergoing cardiopulmonary bypass (CPB) for various cardiac operations were divided into 2 groups. PGE1 group consisted of 10 patients (7 males and 3 females) and the control group consisted of 10 patients (6 males and 4 females). In PGE1 group patients, 20-50 ng/kg/min of PGE1 was administered intravenously from the induction of anesthesia to the completion of CPB. Blood samples were taken before, during, after CPB, and in the morning of the first postoperative day. Differential counts of white blood cells, plasma neutrophil elastase (PNEL) activity, serum complements activity (C3a, CH50) and superoxide production of neutrophils were measured. Superoxide production by isolated neutrophils was evaluated utilizing luminol dependent chemiluminescence. After the initiation of CPB complements were activated markedly, and PNEL activity increased significantly in both groups. Although after CPB PNEL activity turned to decrease, it was still significantly higher on the first postoperative day than the preoperative value. There were no significant differences between two groups as for complements activation and PNEL activity. The total number of white blood cells unchanged during CPB and neutrophilia appeared after CPB, but no significant difference between two groups. Superoxide production of neutrophils relatively decreased during CPB and significantly increased after CPB in the control group. However, in PGE1 group superoxide production was reduced after CPB, especially on the first postoperative day. These results showed that PGE1 reduced neutrophil-mediated superoxide production in open heart surgery. In conclusions, PGE1 is useful agent to reduce the hazardous effects of neutrophils after CPB.
本研究旨在证明前列腺素E1（PGE1）在心脏直视手术中对中性粒细胞激活的影响。20例接受各种心脏手术体外循环（CPB）的成年患者被分为2组。PGE1组由10例患者（7例男性和3例女性）组成，对照组由10例患者（6例男性和4例女性）组成。在PGE1组患者中，从麻醉诱导至CPB结束静脉输注20 - 50 ng/kg/min的PGE1。在CPB前、CPB期间、CPB后以及术后第一天早晨采集血样。检测白细胞分类计数、血浆中性粒细胞弹性蛋白酶（PNEL）活性、血清补体活性（C3a、CH50）以及中性粒细胞的超氧化物生成。利用鲁米诺依赖的化学发光法评估分离的中性粒细胞的超氧化物生成。CPB开始后补体明显激活，两组的PNEL活性均显著增加。虽然CPB后PNEL活性转而下降，但术后第一天仍显著高于术前值。两组在补体激活和PNEL活性方面无显著差异。CPB期间白细胞总数无变化，CPB后出现中性粒细胞增多，但两组之间无显著差异。对照组中性粒细胞的超氧化物生成在CPB期间相对减少，CPB后显著增加。然而，在PGE1组中，CPB后超氧化物生成减少，尤其是在术后第一天。这些结果表明，PGE1在心脏直视手术中减少了中性粒细胞介导的超氧化物生成。总之，PGE1是一种有助于减少CPB后中性粒细胞有害作用的药物。
