Toft P, Tønnesen E, Zülow I, Nielsen C H, Hokland M
Department of Anaesthesiology and Intensive Care, Skejby University Hospital, Aarhus, Denmark.
Scand Cardiovasc J. 1997;31(2):91-5. doi: 10.3109/14017439709058075.
Open-heart surgery with cardiopulmonary bypass (CPB) and abdominal surgery are associated with lymphocytopenia. We measured a panel of adhesion and activation molecules on lymphocytes to clarify possible association of CPB with increased expression of these molecules. Eight patients undergoing open-heart surgery and eight with abdominal surgery were studied. The adhesion molecules CD11a/CD18 (LFA-1_, CD11c/CD18 and CD44 and the activation molecules CD25, CD69, CD71 and MHCII were measured, using monoclonal antibodies and flow cytometry. Lymphocytopenia was observed during CPB and for some hours after both open-heart and abdominal surgery. The proportion of CD11a/CD18-positive lymphocytes rose from 67.6 +/- 8% to 86.4 +/- 3% after aortic declamping (p < 0.05). The expression of activation molecules CD25, CD69 and CD71 was unchanged during and after open-heart as well as abdominal operations. Thus CPB was associated with increased expression of the adhesion molecule CD11a/CD18 on lymphocytes, while the expression of activation molecules on lymphocytes was unchanged.
体外循环（CPB）下的心脏直视手术和腹部手术都与淋巴细胞减少有关。我们检测了淋巴细胞上一组黏附分子和活化分子，以阐明CPB与这些分子表达增加之间可能存在的关联。研究了8例接受心脏直视手术的患者和8例接受腹部手术的患者。使用单克隆抗体和流式细胞术检测黏附分子CD11a/CD18（淋巴细胞功能相关抗原-1α，LFA-1α）、CD11c/CD18和CD44以及活化分子CD25、CD69、CD71和主要组织相容性复合体II类分子（MHCII）。在CPB期间以及心脏直视手术和腹部手术后的数小时内均观察到淋巴细胞减少。主动脉钳夹解除后，CD11a/CD18阳性淋巴细胞的比例从67.6±8%升至86.4±3%（p<0.05）。在心脏直视手术和腹部手术期间及术后，活化分子CD25、CD69和CD71的表达均未改变。因此，CPB与淋巴细胞上黏附分子CD11a/CD18表达增加有关，而淋巴细胞上活化分子的表达未改变。
