Nilsson L, Nilsson U, Venge P, Johansson O, Tydén H, Aberg T, Nyström S O
Department of Thoracic Surgery, University Hospital, Uppsala, Sweden.
Scand J Thorac Cardiovasc Surg. 1990;24(1):53-8. doi: 10.3109/14017439009101824.
As the exposure of blood to foreign material during cardiopulmonary bypass (CPB) leads to triggering of inflammatory systems, the inflammatory response was used as an indicator of the biocompatibility of oxygenators. Activation of complement and neutrophil granulocytes during CPB was studied in 96 patients undergoing coronary bypass, with randomized comparisons between four different oxygenators, two of bubble and two of membrane type. Seven patients undergoing thoracotomy without CPB served as controls. During CPB there was significant complement activation, measured as changes in the ratio C3d/C3, with no demonstrable difference between the bubble and membrane oxygenator groups. Such change was not seen in the controls. Neutrophil granulocytes released significant amounts of the granule proteins lactoferrin and myeloperoxidase during CPB, but not during thoracotomy without CPB. The plasma concentrations of lactoferrin and myeloperoxidase were significantly lower in the membrane oxygenator groups, possibly indicating better biocompatibility. The strong inflammatory response with both oxygenator types, however, indicates that presently used CPB devices have unsatisfactory biocompatibility.
由于在体外循环（CPB）期间血液与异物接触会引发炎症系统，炎症反应被用作氧合器生物相容性的指标。对96例接受冠状动脉搭桥手术的患者在CPB期间补体和中性粒细胞的激活情况进行了研究，将四种不同的氧合器（两种鼓泡式和两种膜式）进行随机比较。7例未进行CPB的开胸手术患者作为对照。在CPB期间存在显著的补体激活，以C3d/C3比值的变化来衡量，鼓泡式氧合器组和膜式氧合器组之间没有明显差异。在对照组中未观察到这种变化。中性粒细胞在CPB期间释放了大量的颗粒蛋白乳铁蛋白和髓过氧化物酶，但在未进行CPB的开胸手术期间未释放。膜式氧合器组中乳铁蛋白和髓过氧化物酶的血浆浓度显著较低，这可能表明其生物相容性更好。然而，两种氧合器类型都有强烈的炎症反应，这表明目前使用的CPB装置的生物相容性并不理想。
