Bilfinger T V, Kushnerik V, Bundz S, Liu Y, Stefano G B
Department of Surgery, State University of New York at Stony Brook, USA.
Int J Cardiol. 1996 Apr 26;53 Suppl:S39-46. doi: 10.1016/0167-5273(96)02574-0.
Cardiopulmonary bypass is associated with both cellular immunosuppression and an inflammatory response. Previous studies have demonstrated that morphine, a naturally occurring substance, can downregulate granulocyte, monocyte and endothelial activity. It can even prevent the activation caused by exposing these cells to plasma obtained from patients undergoing cardiopulmonary bypass. The present study demonstrates that preadministering a high dose of morphine (3.3 mg/kg) to pigs prior to cardiopulmonary bypass also diminishes the activation levels of these cells. In animals not given morphine, monocyte activation levels were 45% compared to 14% exposed to the opiate. Granulocytes also exhibited the same statistically significant (P < 0.05) drop in cellular activation. Activation is determined by computer-assisted microscopic image analysis whereby cellular shape is indicative of the cells activity. Additionally, in animals pretreated with morphine, a twofold increase in the number of cells was obtained, indicating that the endothelium also was downregulated.
体外循环与细胞免疫抑制和炎症反应均有关联。先前的研究表明，吗啡这种天然物质能够下调粒细胞、单核细胞及内皮细胞的活性。它甚至可以防止因将这些细胞暴露于接受体外循环患者的血浆而引发的激活反应。本研究表明，在猪进行体外循环之前预先给予高剂量吗啡（3.3毫克/千克），也会降低这些细胞的激活水平。在未给予吗啡的动物中，单核细胞激活水平为45%，而暴露于该阿片类药物的动物为14%。粒细胞在细胞激活方面也呈现出相同的具有统计学意义（P<0.05）的下降。激活是通过计算机辅助显微镜图像分析来确定的，其中细胞形态表明细胞的活性。此外，在用吗啡预处理的动物中，细胞数量增加了两倍，这表明内皮细胞也受到了下调。
