Videm V, Fosse E, Mollnes T E, Garred P, Svennevig J L
Institute for Experimental Medical Research, Ullevaal Hospital, Oslo, Norway.
Ann Thorac Surg. 1990 Sep;50(3):387-91. doi: 10.1016/0003-4975(90)90480-t.
Thirty-three patients admitted for coronary bypass grafting were randomized to cardiopulmonary bypass with a bubble oxygenator (Cobe or Polystan) or a membrane oxygenator (SciMed). Plasma concentrations of C3 activation products and the terminal complement complex were measured using enzyme immunoassays. Both variables increased almost linearly after onset of cardiopulmonary bypass, with maximal concentrations at closure of the sternum. From a baseline of 7.5 to 12.0 arbitrary units (AU)/mL (medians), the concentrations of C3 activation products increased by 117.5 AU/mL (Cobe), 120.5 AU/mL (Polystan), and 213.3 AU/mL (SciMed). The increase in the membrane group was significantly higher than in the two bubble oxygenator groups (p less than 0.01). From a baseline of 0.9 to 1.3 AU/mL, the concentrations of terminal complement complex increased by 5.4 AU/mL (Cobe), 6.6 AU/mL (Polystan), and 7.7 AU/mL (SciMed) (differences not significant). The higher C3 activation caused by the membrane oxygenator may be explained by differences in flow profile and surface area in contact with blood. The study cannot confirm the general assumption that membrane oxygenators lead to lower complement activation than do bubble oxygenators.
33例因冠状动脉搭桥手术入院的患者被随机分为使用鼓泡式氧合器（Cobe或Polystan）或膜式氧合器（SciMed）进行体外循环的两组。使用酶免疫测定法测量血浆中C3激活产物和末端补体复合物的浓度。体外循环开始后，这两个变量几乎呈线性增加，在胸骨闭合时达到最高浓度。C3激活产物的浓度从基线的7.5至12.0任意单位（AU）/mL（中位数）分别增加了117.5 AU/mL（Cobe）、120.5 AU/mL（Polystan）和213.3 AU/mL（SciMed）。膜式氧合器组的增加显著高于两个鼓泡式氧合器组（p小于0.01）。末端补体复合物的浓度从基线的0.9至1.3 AU/mL分别增加了5.4 AU/mL（Cobe）、6.6 AU/mL（Polystan）和7.7 AU/mL（SciMed）（差异不显著）。膜式氧合器引起的较高C3激活可能是由于血流分布和与血液接触的表面积不同所致。该研究无法证实膜式氧合器比鼓泡式氧合器导致更低补体激活的一般假设。
