Shatney C H, Benner C
Circ Shock. 1985;16(1):9-17.
The complement system has been implicated in the physiopathology of septic shock. Since infection is a major cause of death in trauma patients, we examined daily serum C3 and immunoglobulin levels in all victims of major trauma during a 3-month interval. Sixteen patients developed acute systemic sepsis 3-15 days after admission. For all variables the lowest values occurred shortly after hospital admission, during or just after fluid resuscitation. Thereafter, the serum C3 and immunoglobulin concentrations gradually returned to the normal ranges, despite the onset of fulminant systemic sepsis. Except for IgM, the occurrence of hypotension during sepsis did not affect the recovery patterns of the measured variables. In the five patients experiencing hypotension, serum IgM dropped transiently but resumed its normalization trend after the restoration of adequate perfusion pressure. In the three nonsurvivors there was no reduction in the serum C3 or immunoglobulin levels prior to death. These data do not support a role for C3 or the immunoglobulins in the pathogenesis of acute fulminant clinical sepsis. On the contrary, the behavior of these substances during severe sepsis is more consistent with protective host defense functions.
补体系统与脓毒性休克的病理生理过程有关。由于感染是创伤患者死亡的主要原因，我们在3个月的时间间隔内检测了所有严重创伤患者的每日血清C3和免疫球蛋白水平。16名患者在入院后3 - 15天发生了急性全身性败血症。对于所有变量，最低值出现在入院后不久，在液体复苏期间或刚结束后。此后，尽管爆发了暴发性全身性败血症，但血清C3和免疫球蛋白浓度逐渐恢复到正常范围。除IgM外，败血症期间低血压的发生并不影响所测变量的恢复模式。在5名发生低血压的患者中，血清IgM短暂下降，但在恢复足够的灌注压力后恢复了正常化趋势。在3名非幸存者中，死亡前血清C3或免疫球蛋白水平没有降低。这些数据不支持C3或免疫球蛋白在急性暴发性临床败血症发病机制中的作用。相反，这些物质在严重败血症期间的表现更符合保护性宿主防御功能。
