Sakai H, Katayama Y, Matsuyama T, Harano Y, Murashita T, Komai H, Yamamoto F, Fujita T
Department of Clinical Laboratory, National Cardiovascular Center Hospital, Suita.
Rinsho Byori. 1990 Mar;38(3):295-300.
In order to evaluate the immune response during and after open heart surgery, we have studied 34 patients who received open heart surgery under extracorporeal circulation. Age range of these patients were from 41 to 76 years. These patients were divided into three groups, depending upon existence of multiple organ failure (MOF), low output syndrome (LOS) and non-LOS and non-MOF diagnosed from our criteria. The following cytological and immunological study has been performed pre-operatively, immediately after and on 1, 2, 7 and 14th postoperative day; 1) the leukocyte differential cell count, 2) function test of neutrophils, 3) lymphocyte subpopulation and subsets, 4) serum level of complement fractions (C3, C4) and CH 50. By lymphocytes analysis, postoperative early reduction of OKT 3 (CD 3) and OKT 4 (CD 4) was observed in patients with poor prognosis. Patients with the postoperative high activity of NBT reduction test was developed into MOF. Complement activity (C3, C4, CH50) decreased during surgery and recovered to preoperative level in patients without LOS and MOF. However in MOF patients, these values showed lower level than that of patients without LOS and MOF. Our data suggested that lymphocytes and leukocytes tests were useful to evaluate the prognosis in open heart surgery.
为了评估心脏直视手术期间及术后的免疫反应，我们研究了34例在体外循环下接受心脏直视手术的患者。这些患者的年龄范围为41至76岁。根据我们的标准诊断出的多器官功能衰竭（MOF）、低心排血量综合征（LOS）以及非LOS和非MOF情况，将这些患者分为三组。在术前、术后即刻以及术后第1、2、7和14天进行了以下细胞学和免疫学研究：1）白细胞分类计数；2）中性粒细胞功能测试；3）淋巴细胞亚群和子集；4）补体成分（C3、C4）和CH50的血清水平。通过淋巴细胞分析，预后较差的患者术后早期OKT 3（CD 3）和OKT 4（CD 4）减少。术后NBT还原试验活性高的患者发展为MOF。在没有LOS和MOF的患者中，补体活性（C3、C4、CH50）在手术期间降低，并恢复到术前水平。然而，在MOF患者中，这些值低于没有LOS和MOF的患者。我们的数据表明，淋巴细胞和白细胞检测有助于评估心脏直视手术的预后。
