Ljunghusen O, Cederholm I, Lundahl J, Nilsson B, Olin C, Sjögren F, Stendahl O
Department of Medical Microbiology and Immunology, University Hospital, Linköping, Sweden.
Artif Organs. 1997 Oct;21(10):1091-7. doi: 10.1111/j.1525-1594.1997.tb00448.x.
In this study of 31 patients with coronary bypass surgery, we used flow cytometry to compare heparin-coated and noncoated cardiopulmonary bypass systems on leukocyte activation. We found significant differences between the groups during bypass, with activation of the complement system, measured as elevated levels of C3a desArg, upregulation of granulocyte beta2 integrin (CD11b), and a loss of circulating monocytes when noncoated systems were used. In both groups an early increase in the monocyte cell surface CD62L expression was obvious while the percentage of human leukocyte antigen (HLA)-DR positive monocytes did not alter. The morning after the operation, leukocytosis was present, together with a highly significant reduction in the monocyte expression of CD11b and HLA-DR, indicating the recruitment to the peripheral blood of cells with altered phenotypes. This alteration in phenotype on potent inflammatory cells may be one part of the impaired function of the immunological system reported after major surgery.
在这项针对31例行冠状动脉搭桥手术患者的研究中，我们使用流式细胞术比较了肝素涂层和非涂层体外循环系统对白细胞激活的影响。我们发现，在体外循环期间，两组之间存在显著差异，使用非涂层系统时，补体系统被激活，表现为C3a去精氨酸水平升高、粒细胞β2整合素（CD11b）上调以及循环单核细胞减少。两组中单核细胞表面CD62L表达均早期明显增加，而人类白细胞抗原（HLA）-DR阳性单核细胞百分比未改变。术后次日早晨，出现白细胞增多，同时单核细胞CD11b和HLA-DR表达显著降低，表明表型改变的细胞被募集到外周血中。这种强效炎症细胞表型的改变可能是大手术后免疫系统功能受损的一部分原因。
