Hauser G J, Chan M M, Casey W F, Midgley F M, Holbrook P R
Department of Critical Care Medicine, Georgetown University Children's Medical Center, Washington, DC 20007.
Crit Care Med. 1991 Jul;19(7):874-81. doi: 10.1097/00003246-199107000-00009.
To study the effect of open- and closed-heart surgery on the immune status of infants and children.
Prospective study. Data collected before anesthesia and surgery and 2 and 24 hrs after surgery.
Operating room and pediatric ICU in a children's hospital.
Children undergoing surgery for correction of congenital heart disease (age 3 months to 12 yrs). A total of 31 patients were studied (open-heart surgery, n = 25; closed-heart surgery, n = 6).
Increased neutrophil counts and lymphopenia were observed after both open- and closed-heart surgery. Serum levels of the complement components C3 and C4 were depressed after open-heart surgery, but not after closed procedures. The percentage of T3+ and T4+ lymphocytes, proliferative responses of the lymphocytes and serum immunoglobulin (Ig)G and IgM were decreased from preoperative levels after open-heart surgery. The percentage of T8+ lymphocytes and serum IgA levels did not change. Intraoperative variables and postoperative severity of illness (Pediatric Risk of Mortality score) did not correlate with immune suppression.
The immune system is affected after pediatric cardiac surgery, particularly after open-heart surgery.
研究心脏直视手术和非心脏直视手术对婴幼儿及儿童免疫状态的影响。
前瞻性研究。于麻醉和手术前以及术后2小时和24小时收集数据。
儿童医院的手术室和儿科重症监护病房。
接受先天性心脏病矫正手术的儿童（年龄3个月至12岁）。共研究了31例患者（心脏直视手术，n = 25；非心脏直视手术，n = 6）。
心脏直视手术和非心脏直视手术后均观察到中性粒细胞计数增加和淋巴细胞减少。心脏直视手术后补体成分C3和C4的血清水平降低，但非心脏直视手术后未降低。心脏直视手术后，T3 +和T4 +淋巴细胞的百分比、淋巴细胞增殖反应以及血清免疫球蛋白（Ig）G和IgM均较术前水平降低。T8 +淋巴细胞的百分比和血清IgA水平未发生变化。术中变量和术后疾病严重程度（儿科死亡风险评分）与免疫抑制无关。
小儿心脏手术后免疫系统受到影响，尤其是心脏直视手术后。
