Cavarocchi N C, England M D, Schaff H V, Russo P, Orszulak T A, Schnell W A, O'Brien J F, Pluth J R
Circulation. 1986 Nov;74(5 Pt 2):III130-3.
To determine the relationships among complement activation, pulmonary leukosequestration, and oxygen free radical generation, we prospectively studied 15 patients undergoing cardiopulmonary bypass for myocardial revascularization. Plasma levels of C3a, C4a, and hydrogen peroxide (a marker of oxygen free radical generation) were measured before, during, and after extracorporeal circulation. The results confirm that cardiopulmonary bypass activates complement via the alternate (C3a) pathway. This first phase of complement activation was accompanied by an increase in plasma H2O2 (from 80 +/- 8 to 155 +/- 13 microM/ml; p less than .001) and by pulmonary sequestration of polymorphonuclear leukocytes. Protamine administration after cardiopulmonary bypass further activated complement via the classical (C4a) pathway but was not accompanied by a change in plasma hydrogen peroxide. We hypothesize that both complement activation and excess oxygen free radical generation contribute to the pathophysiology of extracorporeal circulation.
为了确定补体激活、肺白细胞扣押和氧自由基生成之间的关系，我们前瞻性地研究了15例接受体外循环心肌血运重建术的患者。在体外循环前、期间和之后，测量了血浆中C3a、C4a和过氧化氢（氧自由基生成的标志物）的水平。结果证实，体外循环通过替代（C3a）途径激活补体。补体激活的第一阶段伴随着血浆H2O2的增加（从80±8微摩尔/毫升增加到155±13微摩尔/毫升；p＜0.001）以及多形核白细胞在肺部的扣押。体外循环后给予鱼精蛋白通过经典（C4a）途径进一步激活补体，但血浆过氧化氢没有变化。我们推测补体激活和过量氧自由基生成均有助于体外循环的病理生理学。
