Bengtson J P, Backman L, Stenqvist O, Heideman M, Bengtsson A
Department of Anesthesiology and Intensive Care, Sahlgren's Hospital, Gothenburg, Sweden.
Anesthesiology. 1990 Sep;73(3):376-80. doi: 10.1097/00000542-199009000-00002.
Eighteen patients undergoing total hip replacement (n = 13) or knee arthroplasty (n = 5) due to osteoarthritis or osteoarthrosis were prospectively studied in an investigation of complement activation and anaphylatoxin release in association with reinfusion of aspirated wound blood. Twelve of the patients needed blood transfusions and received an average of 390 +/- 75 ml (+/- SD) of autologous blood within 45 min. Plasma complement components, anaphylatoxins, and inhibitors were studied 1 min before and 15 min after the start of and 15 min after the completion of autologous transfusion. Samples also were taken from the collected blood, before and after passing it through a microporous filter. Blood gases and systemic complement samples were drawn simultaneously. There were no significant changes in systemic complement variables before, during, or after transfusion of autologous blood. However, in the aspirated blood, increased concentration of anaphylatoxins (C3a and C5a) and terminal complement complexes (TCC) were present (P less than 0.001). There were no differences observed between samples drawn before and after filtration of the blood. The concentration of C5 was less in the collected blood than in the systemic blood (P less than 0.05). No changes in blood gases were observed. This study demonstrated that postoperatively salvaged whole blood underwent anaphylatoxin formation and complement activation. However, after reinfusion of this blood, neither systemic complement activation nor clinical complications were observed.
对18例因骨关节炎或骨关节病接受全髋关节置换术（n = 13）或膝关节置换术（n = 5）的患者进行了前瞻性研究，以调查与回输吸出的伤口血液相关的补体激活和过敏毒素释放情况。其中12例患者需要输血，在45分钟内平均接受了390±75 ml（±标准差）的自体血。在自体输血开始前1分钟、开始后15分钟和完成后15分钟对血浆补体成分、过敏毒素和抑制剂进行了研究。还在收集的血液通过微孔过滤器前后分别取样。同时采集血气和全身补体样本。自体输血前、输血期间或输血后全身补体变量均无显著变化。然而，在吸出的血液中，过敏毒素（C3a和C5a）和末端补体复合物（TCC）的浓度升高（P<0.001）。血液过滤前后采集的样本之间未观察到差异。收集的血液中C5的浓度低于全身血液中的浓度（P<0.05）。未观察到血气变化。本研究表明，术后回收的全血会发生过敏毒素形成和补体激活。然而，回输这种血液后，未观察到全身补体激活或临床并发症。
