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体外循环后呼吸并发症的临床研究,特别涉及补体激活、白细胞及粒细胞弹性蛋白酶

[A clinical study of respiratory complication after cardiopulmonary bypass, with special reference to complement activation, WBC and granulocyte elastase].

作者信息

Nagamine S, Tabayashi K, Haneda K, Mohri H

机构信息

Department of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1994 May;95(5):348-53.

PMID:8007941
Abstract

Complement activation and it's influence on lung injury were studied in 20 patients undergoing cardiopulmonary bypass (CPB). Anaphylatoxins increased remarkably to 3130 +/- 1770 ng/ml in C3a, 2480 +/- 2530 ng/ml in C4a and granulocytes were significantly fewer in left atrium (LA) than right atrium (RA) during CPB. Granulocyte elastase (GEL) was significantly higher in LA than RA at the time of reperfusion. Postoperative respiratory index was well correlated with C3a and GEL. We concluded that lung injury after CBP was caused by anaphylatoxin which aggregated granulocyte in pulmonary vasculature and released GEL during CPB, and anaphylatoxin was produced not only by using CBP but in patient's lung.

摘要

对20例接受体外循环(CPB)的患者进行了补体激活及其对肺损伤影响的研究。过敏毒素显著增加,C3a达3130±1770 ng/ml,C4a达2480±2530 ng/ml,且在CPB期间左心房(LA)的粒细胞明显少于右心房(RA)。再灌注时LA的粒细胞弹性蛋白酶(GEL)明显高于RA。术后呼吸指数与C3a和GEL密切相关。我们得出结论,CPB后肺损伤是由过敏毒素引起的,过敏毒素在CPB期间使粒细胞聚集在肺血管中并释放GEL,且过敏毒素不仅由CPB产生,患者肺部也会产生。

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