Freeman R, Gould F K
Thorax. 1985 Jul;40(7):538-41. doi: 10.1136/thx.40.7.538.
Paired sera, taken before operation and 10-14 days after operation from 64 patients having open heart surgery and 10 having closed heart surgery, were examined for agglutinins to seven common serotypes of Escherichia coli. The results showed that, while 20% of both groups of patients had detectable agglutinins before operation, new antibodies appeared after operation in 69% of patients having open heart surgery compared with only 10% of those having closed heart surgery, a significant difference. Thirty six pairs of sera were also examined for the preoperative presence and postoperative development of antiendotoxin. Of 22 open heart patients shown not to possess antiendotoxin before operation, 18 showed the antibody after operation, whereas none of the eight seronegative patients acquired the antibody after closed heart surgery-again a highly significant difference. These results are consistent with the hypothesis that endotoxin and other products of enteric Gram negative bacilli circulate shortly after cardiopulmonary bypass, possibly arising directly from the gut and perhaps explaining the pyrexia seen commonly at this time.
从64例接受心脏直视手术的患者和10例接受心脏闭式手术的患者身上，分别采集术前及术后10 - 14天的配对血清，检测其对七种常见血清型大肠杆菌的凝集素。结果显示，两组患者术前均有20%可检测到凝集素，但心脏直视手术患者术后有69%出现新抗体，而心脏闭式手术患者术后仅有10%出现新抗体，差异显著。还对36对血清检测了术前抗内毒素的存在情况及术后抗内毒素的产生情况。在22例术前未检测到抗内毒素的心脏直视手术患者中，18例术后出现了该抗体，而8例血清阴性的心脏闭式手术患者术后均未产生该抗体——同样差异极为显著。这些结果与以下假说相符：内毒素及肠道革兰氏阴性杆菌的其他产物在体外循环后不久即进入循环，可能直接源自肠道，这或许可以解释此时常见的发热现象。
