Bozdayi M, Borowiec J, Nilsson L, Venge P, Thelin S, Hansson H E
Department of Clinical Chemistry, University Hospital, Uppsala, Sweden.
Artif Organs. 1996 Sep;20(9):1008-16. doi: 10.1111/j.1525-1594.1996.tb04588.x.
During cardiopulmonary bypass (CPB) oxygen free radicals (OFR) are formed, which can mediate reactions damaging tissue components. Blood contact with artificial surfaces during CPB leads to an activation of leukocytes, which are one of the sources of the OFR. Heparin coating of the CPB circuit reduces granulocyte activation. In the present study, the heparin-coated circuits with noncoated cardiotomy reservoirs (Group HC) were compared with noncoated, otherwise similar CPB sets (Group C). In each group, 8 patients were operated on for coronary revascularization. The release of granulocyte granule proteins myeloperoxidase (MPO) and lactoferrin (LF) was evaluated. Production of OFR in the whole blood and in the granulocyte suspension were measured by chemiluminescence (CL). In both groups the whole blood CL declined during CPB. The whole blood CL induced by serum-opsonized zymosan, when enhanced by luminol, was significantly lower in Group HC at 45 min after CPB start (68 +/- 6% of initial values in Group HC vs. 87 +/- 6% in Group C, mean +/- SEM) and 30 min after protaminization (54 +/- 6% of initial values in Group HC vs. 72 +/- 6% in Group C, mean +/- SEM), and CL was significantly higher in Group HC at CPB end (83 +/- 5% of initial values in Group HC vs. 67 +/- 5% in Group C, mean +/- SEM) when enhanced by lucigenin. CL of isolated granulocytes showed no significant differences between the groups. Release of MPO at CPB end and of LF 45 min after start of CPB and at CPB end were significantly lower in the heparin-coated CPB circuits.
在体外循环（CPB）期间会形成氧自由基（OFR），其可介导损害组织成分的反应。CPB期间血液与人工表面接触会导致白细胞活化，而白细胞是OFR的来源之一。CPB回路的肝素涂层可减少粒细胞活化。在本研究中，将带有未涂层心内吸引贮血器的肝素涂层回路（HC组）与未涂层但其他方面相似的CPB装置（C组）进行了比较。每组有8例患者接受冠状动脉血运重建手术。评估了粒细胞颗粒蛋白髓过氧化物酶（MPO）和乳铁蛋白（LF）的释放情况。通过化学发光（CL）测量全血和粒细胞悬液中OFR的产生。两组在CPB期间全血CL均下降。在CPB开始后45分钟，当用鲁米诺增强时，血清调理酵母聚糖诱导的全血CL在HC组显著低于C组（HC组为初始值的68±6%，C组为87±6%，均值±标准误），在鱼精蛋白化后30分钟也是如此（HC组为初始值的54±6%，C组为72±6%，均值±标准误）；当用光泽精增强时，CPB结束时HC组的CL显著高于C组（HC组为初始值的83±5%，C组为67±5%，均值±标准误）。分离的粒细胞的CL在两组之间无显著差异。肝素涂层的CPB回路在CPB结束时MPO的释放以及CPB开始后45分钟和CPB结束时LF的释放均显著较低。
