Collett B, Alhaq A, Abdullah N B, Korjtsas L, Ware R J, Dodd N J, Alimo E, Ponte J, Vergani D
Br Med J (Clin Res Ed). 1984 Nov 10;289(6454):1251-4. doi: 10.1136/bmj.289.6454.1251.
Complement activation was assessed in 34 patients undergoing cardiopulmonary bypass. Arterial concentrations of complement fragments Ba and C3d rose in all patients, the increase in Ba preceding that of C3d. At the same time as complement fragments were being generated the arterial neutrophil count fell. These findings suggest (a) that complement activation is initiated by the alternative pathway during cardiopulmonary bypass and (b) that complement activation mediates loss of neutrophils during bypass. Complement mediated loss of neutrophils during the analogous setting of haemodialysis is the result of leucosequestration in the pulmonary vasculature. During cardiopulmonary bypass the lungs are out of circuit, so that activated leucocytes may sequester in other target organs. This may be an aetiological factor in the multi-organ failure occasionally seen after uneventful cardiopulmonary bypass.
对34例接受体外循环的患者进行了补体激活评估。所有患者的动脉血中补体片段Ba和C3d浓度均升高，Ba的升高先于C3d。在补体片段产生的同时，动脉血中性粒细胞计数下降。这些发现表明：（a）体外循环期间补体激活由替代途径启动；（b）补体激活介导了体外循环期间中性粒细胞的丢失。在血液透析类似情况下，补体介导的中性粒细胞丢失是肺血管中白细胞扣押的结果。体外循环期间肺不参与循环，因此活化的白细胞可能在其他靶器官中扣押。这可能是在顺利完成体外循环后偶尔出现多器官功能衰竭的一个病因学因素。
