Gillinov A M, Bator J M, Zehr K J, Redmond J M, Burch R M, Ko C, Winkelstein J A, Stuart R S, Baumgartner W A, Cameron D E
Department of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Ann Thorac Surg. 1993 Oct;56(4):847-53. doi: 10.1016/0003-4975(93)90342-f.
The neutrophil-mediated tissue injury associated with cardiopulmonary bypass (CPB) is thought to require the interaction of specific neutrophil and endothelial adhesion molecules. In this study, the effects of CPB on the expression of neutrophil CD11b and CD18 (the components of the Mac-1 adhesion molecule) were examined; the effects of membrane versus bubble oxygenators on the expression of neutrophil CD11b and CD18 were compared; and the plasma levels of the intercellular adhesion molecule-1 (cICAM-1), an inducible endothelial adhesion molecule, were measured. In addition, the time courses of complement activation and neutrophil granule release were measured to determine their temporal relationship to the expression of the neutrophil adhesion molecule. Fifteen adult patients underwent procedures requiring cardiopulmonary bypass; hollow-fiber membrane oxygenators were used in 8 (group M) and bubble oxygenators were used in 7 (group B). Blood samples were drawn before, during, and after CPB for determination of the expression of neutrophil CD11b and CD18 (immunofluorescent flow cytometry), and the plasma cICAM-1, elastase, lactoferrin (enzyme-linked immunoabsorbent assay), and plasma C3a (radioimmunoassay) levels. CPB caused an immediate and sustained increase in the neutrophil CD11b and CD18 expression in both groups; after 60 minutes of CPB, CD11b expression had increased by 116.9% +/- 19.1% in group B and by 79.3% +/- 8.5% in group M (p = 0.78). Over the same period, CD18 expression increased by 97.2% +/- 17.9% in group B and by 72.4% +/- 16.8% in group M (p = 0.67).(ABSTRACT TRUNCATED AT 250 WORDS)
与体外循环（CPB）相关的中性粒细胞介导的组织损伤被认为需要特定的中性粒细胞和内皮黏附分子相互作用。在本研究中，检测了CPB对中性粒细胞CD11b和CD18（Mac-1黏附分子的组成部分）表达的影响；比较了膜式氧合器与鼓泡式氧合器对中性粒细胞CD11b和CD18表达的影响；并测定了诱导性内皮黏附分子细胞间黏附分子-1（cICAM-1）的血浆水平。此外，还测定了补体激活和中性粒细胞颗粒释放的时间进程，以确定它们与中性粒细胞黏附分子表达的时间关系。15例成年患者接受了需要体外循环的手术；8例使用中空纤维膜式氧合器（M组），7例使用鼓泡式氧合器（B组）。在CPB前、中、后采集血样，用于测定中性粒细胞CD11b和CD18的表达（免疫荧光流式细胞术），以及血浆cICAM-1、弹性蛋白酶、乳铁蛋白（酶联免疫吸附测定）和血浆C3a（放射免疫测定）水平。CPB使两组中性粒细胞CD11b和CD18表达立即且持续增加；CPB 60分钟后，B组CD11b表达增加了116.9%±19.1%，M组增加了79.3%±8.5%（p = 0.78）。在同一时期，B组CD18表达增加了97.2%±17.9%，M组增加了72.4%±16.8%（p = 0.67）。（摘要截取自250字）
