Gianotti L, Pyles T, Alexander J W, Fukushima R, Babcock G F
Department of Surgery, University of Cincinnati Medical Center, Ohio.
Transfusion. 1993 Jun;33(6):458-65. doi: 10.1046/j.1537-2995.1993.33693296806.x.
It has previously been reported that the transfusion of allogeneic whole blood increases sepsis-related mortality and decreases the ability of the host to kill bacteria that have translocated from the intestinal tract. To determine which blood component contributes to this adverse effect, the impact of the transfusion of white cells (WBCs), red cells (RBCs), and plasma on microbial translocation, bacteria killing, and mortality rate was studied. Blood from C3H/HeJ mice was separated into WBCs, RBCs, and plasma, and these fractions were transfused to Balb/c mice. Controls received sterile saline. Five days after transfusion, all Balb/c mice underwent a 20-percent burn and gavage with 1 x 10(10) Escherichia coli labeled with 14C-glucose. Mortality was observed for 10 days. Four additional groups, receiving the same treatment as above, were sacrificed 4 hours after the burn, and mesenteric lymph nodes, liver, kidney, and blood were harvested aseptically. For each tissue, quantitative colony counts, radionuclide counts, and percentage of translocated bacteria that remained alive were calculated. By radionuclide counts, no difference was observed in the degree of 14C E. coli translocation among the groups. In contrast, the percentage of viable bacteria and the mortality rate were significantly higher in the group receiving allogeneic WBCs than in all other groups (p < 0.05). It is concluded that WBCs are the component in transfused blood that has an adverse effect on host resistance to gut-derived infection.
此前有报道称，输注异体全血会增加脓毒症相关死亡率，并降低宿主杀灭从肠道移位而来细菌的能力。为确定哪种血液成分会导致这种不良影响，研究了输注白细胞（WBC）、红细胞（RBC）和血浆对微生物移位、细菌杀灭及死亡率的影响。将C3H/HeJ小鼠的血液分离为白细胞、红细胞和血浆，然后将这些组分输注给Balb/c小鼠。对照组接受无菌生理盐水。输血后5天，所有Balb/c小鼠均遭受20%体表面积的烧伤，并经口灌喂1×10¹⁰个用¹⁴C -葡萄糖标记的大肠杆菌。观察10天的死亡率。另外四组接受与上述相同的处理，在烧伤后4小时处死，无菌采集肠系膜淋巴结、肝脏、肾脏和血液。对每个组织计算定量菌落计数、放射性核素计数以及存活的移位细菌百分比。通过放射性核素计数，各实验组间¹⁴C大肠杆菌的移位程度未观察到差异。相比之下，接受异体白细胞组的活菌百分比和死亡率显著高于所有其他组（p<0.05）。得出的结论是，白细胞是输注血液中对宿主抵抗肠道源性感染产生不良影响的成分。
