Scovill W A, Annest S J, Saba T M, Blumenstock F A, Newell J C, Stratton H H, Powers S R
Surgery. 1979 Aug;86(2):284-93.
Depression of reticuloendothelial (RE) phagocytic function has been clearly documented following trauma and operation. This phagocytic failure is mediated in part by depletion of an opsonic glycoprotein. Depletion of this opsonic protein may result in prolonged blood retention of potentially harmful particulates that may interfere with the microcirculation and may possibly result in altered organ function. Isolation and identification of this opsonic protein has led to the finding of the identity between opsonic glycoprotein and cold insoluble globulin (CIg) or so-called plasma fibronectin. Since CIg is concentrated in cryoprecipitate, this blood component was used as a readily available source of opsonic protein for replacement studies. Nine patients were studied following a 1-hour infusion of cryoprecipitate obtained from 10 units of plasma and suspended in a volume of 250 ml. Both the pulmonary shunt fraction and the fraction of dead space ventilation decreased significantly (P = 0.02) after cryoprecipitate administration. Limb blood flow (P = 0.001), limb oxygen consumption (P = 0.001), and reactive hyperemia of the limb (P = 0.05) increased significantly following cryoprecipitate infusion. Cardiac output, total oxygen consumption did not change consistently. The data demonstrate that the infusion of cryoprecipitate resulted in improved pulmonary and microcirculatory function--possibly due to opsonic glycoprotein replacement.
创伤和手术后，网状内皮（RE）系统吞噬功能的抑制已得到明确证实。这种吞噬功能衰竭部分是由调理素糖蛋白的消耗介导的。这种调理素蛋白的消耗可能导致潜在有害颗粒在血液中的滞留时间延长，这可能会干扰微循环，并可能导致器官功能改变。这种调理素蛋白的分离和鉴定导致发现调理素糖蛋白与冷不溶性球蛋白（CIg）或所谓的血浆纤连蛋白是同一物质。由于CIg集中在冷沉淀中，这种血液成分被用作调理素蛋白的现成来源进行替代研究。对9名患者进行了研究，他们输注了从10单位血浆中获得的冷沉淀，将其悬浮在250毫升体积中，输注时间为1小时。输注冷沉淀后，肺分流分数和死腔通气分数均显著降低（P = 0.02）。输注冷沉淀后，肢体血流量（P = 0.001）、肢体氧耗量（P = 0.001）和肢体反应性充血（P = 0.05）均显著增加。心输出量、总氧耗量没有持续变化。数据表明，输注冷沉淀可改善肺和微循环功能——可能是由于调理素糖蛋白的替代作用。
