Mitsuhata H, Enzan K, Hasegawa J, Matumoto S, Matsumoto J, Kurosawa S
Department of Anesthesiology, Hiraka General Hospital, Yokote.
Masui. 1992 Feb;41(2):194-9.
Activation of complement and serum changes in anaphylatoxin (C3a and C5a) were studied in 8 patients who underwent open-heart surgery using a membrane oxygenator. C1 esterase inhibitor (C1-EI), C3, C5, CH50, C3a and C5a were measured serially at 7 points. C1-EI, C3, and C5 were measured by single radial immunodiffusion, CH50 by Mayer's method, and C3a and C5a by radioimmunoassay. Levels of C1-EI, C3 and C5 decreased significantly from 10 min after initiation to 120 min after the end of CPB compared with base line values. Degree of activation of complement increased in proportion to duration of CPB. Significant decreases of C3 and C5 continued until first postoperative day. Level of C3a increased significantly 10 min after initiation of CPB, and gradually increased till immediately after the end of CPB, when the level was maximum (4625 +/- 560 ng.ml-1) among 7 points. Level of C3a decreased gradually till 120 min after end of CPB. C5a was not detected during whole course. No patient showed respiratory distress of pulmonary edema. In conclusion, membrane oxygenator activated classical pathway of complement at 10 min after initiation of CPB. C3a increased significantly from 10 min after initiation of CPB to 120 min after end of CPB, but C5a was not detected at all during the whole course. The significant activation of complement continued till first postoperative day.
对8例使用膜式氧合器进行心脏直视手术的患者，研究了补体激活及过敏毒素（C3a和C5a）的血清变化。在7个时间点连续检测C1酯酶抑制剂（C1-EI）、C3、C5、CH50、C3a和C5a。C1-EI、C3和C5采用单向放射免疫扩散法测定，CH50采用迈耶法测定，C3a和C5a采用放射免疫分析法测定。与基线值相比，体外循环开始后10分钟至结束后120分钟，C1-EI、C3和C5水平显著下降。补体激活程度与体外循环持续时间成正比。C3和C5的显著下降持续至术后第一天。体外循环开始后10分钟，C3a水平显著升高，并逐渐升高直至体外循环结束后即刻达到最高水平（4625±560 ng/ml），为7个时间点中的最高值。C3a水平在体外循环结束后逐渐下降，直至120分钟。整个过程未检测到C5a。无患者出现肺水肿导致的呼吸窘迫。总之，膜式氧合器在体外循环开始后10分钟激活补体经典途径。C3a从体外循环开始后10分钟至结束后120分钟显著升高，但整个过程均未检测到C5a。补体的显著激活持续至术后第一天。
