Imura Hajime, Duncan Heather P, Corfield Anthony P, Myerscough Neil, Caputo Massimo, Angelini Gianni D, Wolf Andrew R, Henderson A John
Bristol Heart Institute, United Kingdom.
J Thorac Cardiovasc Surg. 2004 Apr;127(4):963-9. doi: 10.1016/j.jtcvs.2003.07.034.
Airway mucins may play an important role in the mechanism of respiratory complications after cardiopulmonary bypass in infants and children. Our aim was to measure airway mucin levels before and after cardiopulmonary bypass and to determine whether changes in mucin levels were associated with the development of respiratory complications.
Airway glycoprotein and mucins (MUC5AC, MUC5B, and MUC2) in serial small-volume airway lavage samples from 39 young children who underwent cardiac operations with cardiopulmonary bypass were measured by slot-blot assay with specific antimucin peptide antibodies. The relationship between mucin changes and post-cardiopulmonary bypass respiratory complications was investigated. Airway lavage samples were also collected from 11 children before and after operation without cardiopulmonary bypass, and changes in mucin levels were compared with those in subjects who underwent cardiopulmonary bypass. Airway lavage sample DNA was also measured to investigate the relationship between mucin changes and lung injury.
Glycoprotein, MUC5AC, and MUC5B levels were significantly increased after cardiopulmonary bypass (P <.001) whereas MUC2 level was not. Children with respiratory complications showed significantly higher glycoprotein and MUC5AC levels than did children without respiratory complications before and after cardiopulmonary bypass (P <.05). Increase of total mucin (MUC5AC, MUC5B, and MUC2) during cardiopulmonary bypass showed positive correlation with DNA increase during cardiopulmonary bypass (r = 0.73), PaCO(2) (r = 0.62) and alveolar-arterial oxygen difference (r = 0.55) immediately after cardiopulmonary bypass. Increase of total mucin was associated with postoperative respiratory complications and their severity. There were no significant changes detected in airway mucin during operations without cardiopulmonary bypass.
Airway mucins were increased during cardiopulmonary bypass, and this increase was associated with markers of lung injury after cardiopulmonary bypass and with the development of postoperative respiratory complications.
气道黏蛋白可能在婴幼儿体外循环后呼吸并发症的发生机制中起重要作用。我们的目的是测量体外循环前后的气道黏蛋白水平，并确定黏蛋白水平的变化是否与呼吸并发症的发生有关。
采用特异性抗黏蛋白肽抗体的斑点印迹法，检测39例接受体外循环心脏手术的幼儿连续小容量气道灌洗样本中的气道糖蛋白和黏蛋白（MUC5AC、MUC5B和MUC2）。研究黏蛋白变化与体外循环后呼吸并发症之间的关系。还收集了11例未行体外循环手术的儿童术前和术后的气道灌洗样本，并将黏蛋白水平的变化与接受体外循环的受试者进行比较。同时检测气道灌洗样本DNA，以研究黏蛋白变化与肺损伤之间的关系。
体外循环后糖蛋白、MUC5AC和MUC5B水平显著升高（P<.001），而MUC2水平未升高。有呼吸并发症的儿童在体外循环前后的糖蛋白和MUC5AC水平显著高于无呼吸并发症的儿童（P<.05）。体外循环期间总黏蛋白（MUC5AC、MUC5B和MUC2）的增加与体外循环期间DNA的增加（r = 0.73）、体外循环后即刻的PaCO₂（r = = 0.62）和肺泡-动脉氧分压差（r = 0.55）呈正相关。总黏蛋白的增加与术后呼吸并发症及其严重程度相关。在未行体外循环的手术过程中，气道黏蛋白未检测到显著变化。
体外循环期间气道黏蛋白增加，这种增加与体外循环后肺损伤标志物以及术后呼吸并发症的发生有关。
