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[体外循环期间白细胞滤过过程中血液成分变化的动态。初步结果]

[The dynamics of blood composition changes in leukocyte filtration during cardiopulmonary bypass. Preliminary results].

作者信息

Mihaljevic T, Tönz M, Pasic M, Engel M, von Segesser L K, Turina M

机构信息

Klinik für Herz- und Gefässchirurgie, Universitätsspital Zürich.

出版信息

Helv Chir Acta. 1993 Dec;60(3):403-6.

PMID:8119822
Abstract

Activation of leukocytes (especially neutrophils) during cardiopulmonary bypass (CPB) causes a reperfusion injury through the release of oxygen free radicals and formation of microvascular occlusions. Leukocyte filtration during CPB could solve these drawbacks. We investigated the selectivity of leukocyte filtration by fifteen patients undergoing coronary artery bypass surgery. Leukocyte depleted patients (n = 8) had a leukocyte filter incorporated in the bypass circuit. We evaluated the number of lymphocytes, neutrophils and platelets as well as hematocrit values at following time points: a) before CPB, b) 15 min after the start of CPB, c) before the administration of protamin and d) 3 hours after the CPB. No statistically significant changes of hematocrit values, lymphocyte or platelet counts between control and leukocyte depleted group of patients were observed. However, the use of leukocyte filter caused significant decrease in number of circulating neutrophils at 15 min after begin of CPB (1.20 +/- 0.17 x 10(9)/l for leukocyte depleted patients and 1.90 +/- 0.42 x 10(9)/l for control group of patients, p < 0.05). Our temporary results indicate the selectivity of leukocyte filtration during the cardiopulmonary bypass.

摘要

体外循环(CPB)期间白细胞(尤其是中性粒细胞)的激活通过释放氧自由基和形成微血管阻塞导致再灌注损伤。CPB期间进行白细胞滤过可解决这些缺点。我们对15例接受冠状动脉搭桥手术的患者进行白细胞滤过的选择性研究。白细胞减少的患者(n = 8)在体外循环回路中加入了白细胞滤器。我们在以下时间点评估淋巴细胞、中性粒细胞和血小板的数量以及血细胞比容值:a)CPB前,b)CPB开始后15分钟,c)鱼精蛋白给药前,d)CPB后3小时。在对照组和白细胞减少组患者之间,未观察到血细胞比容值、淋巴细胞或血小板计数有统计学意义的变化。然而,使用白细胞滤器导致CPB开始后15分钟时循环中性粒细胞数量显著减少(白细胞减少患者为1.20±0.17×10⁹/L,对照组患者为1.90±0.42×10⁹/L,p<0.05)。我们的初步结果表明体外循环期间白细胞滤过具有选择性。

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