Merry C, Puri P, Reen D J
Children's Research Centre, Our Lady's Hospital for Sick Children, Dublin, Ireland.
J Pediatr Surg. 1997 Jun;32(6):813-7. doi: 10.1016/s0022-3468(97)90626-6.
The authors have examined the effect of major surgery in neonates and older children on neutrophil (PMN) chemotaxis and on actin polymerization, an essential early step in PMN movement. Isolated PMNs from the following subjects were studied: healthy adult volunteers (n = 28), healthy newborns (n = 21), newborns undergoing major surgery (n = 7), and older infants and children undergoing major surgery (n = 14). Chemotaxis was measured by a micropore filter assay, and actin polymerization was measured by flow cytometry. Blood samples from surgical patients were obtained preoperatively, hourly during the procedure, immediately postoperatively, and 48 hours after surgery. Mean preoperative newborn PMN chemotaxis was similar to that of healthy newborn PMN, and mean preoperative PMN chemotaxis in children was similar to that of healthy adults. There were no significant alterations in PMN chemotaxis during or after major surgery in neonates or children. Peak PMN actin polymerization, after stimulation with formyl methionyl leucyl phenylalanine (FMLP) (10 nm), was significantly diminished in healthy neonates compared with adults (P < .005). Preoperative surgical neonates had similar peak PMN actin polymerization levels to those of healthy newborns, and older preoperative children had similar levels to adults. PMN actin polymerization did not significantly change during or after major surgery. Despite reductions in PMN chemotaxis and actin polymerization in healthy neonates, there is no further impairment of these PMN functions during or after major surgery. Our data suggest that PMN chemotactic function is resistant to the stress of uncomplicated major surgery in neonates and children.
作者研究了新生儿和大龄儿童接受大手术后对中性粒细胞（PMN）趋化性以及肌动蛋白聚合作用的影响，肌动蛋白聚合是PMN运动早期的一个重要步骤。研究了以下受试者的分离PMN：健康成年志愿者（n = 28）、健康新生儿（n = 21）、接受大手术的新生儿（n = 7）以及接受大手术的大龄婴儿和儿童（n = 14）。通过微孔滤膜试验测量趋化性，通过流式细胞术测量肌动蛋白聚合作用。手术患者的血样在术前、手术过程中每小时、术后即刻以及术后48小时采集。术前新生儿PMN趋化性平均值与健康新生儿相似，儿童术前PMN趋化性平均值与健康成年人相似。新生儿或儿童在大手术期间及术后，PMN趋化性无显著改变。与成年人相比，健康新生儿经甲酰甲硫氨酰亮氨酰苯丙氨酸（FMLP）（10 nM）刺激后，PMN肌动蛋白聚合峰值显著降低（P <.005）。术前接受手术的新生儿PMN肌动蛋白聚合峰值水平与健康新生儿相似，术前大龄儿童与成年人相似。大手术期间及术后，PMN肌动蛋白聚合无显著变化。尽管健康新生儿的PMN趋化性和肌动蛋白聚合有所降低，但在大手术期间及术后这些PMN功能并未进一步受损。我们的数据表明，PMN趋化功能对新生儿和儿童单纯性大手术的应激具有抵抗力。
