心脏直视术心肺转流时免疫球蛋白、补体及白细胞动力学的临床观察

对22例体外循环心脏直视手术病人补体、免疫球蛋白及白细胞动力学进行观察,结果提示在心肺转流(CPB)10min、30min 后血清中 C3及 CH50水平与术前相比明显下降(P<0.05～0.001),C4水平仅在注射鱼精蛋白后下降(P<0.05);免疫球蛋白 IgM 水平在 CPB 10min,30min 后与术前相比明显下降(分别 P<0.05及 P<0.025),IgG 及 IgA 水平与术前相比无显著差异。CPB 时未发现中性白细胞减少;补体迅速被激活,主要是通过交替途径;CPB结束及注射鱼精蛋白后则同时通过经典及交替途径激活补体。

Changs in Immunoglobulins, Complements,and Leukocyte Kinetics during Cardiopulmonary Bypass in Open Heart Surgery

Twenty-two patients undergoing cardiopulmonary bypass(CPB)for open heart surgery were studied for changing in complements,immunoglobulins,and leukocyte kinetics.Our results showed that the preoperative serum complement levels of C_3 and CH_(50) have been lower- ed at 10 min and 30 rain after CPB (P<0.05-<0.001),and C_4 would be lowered only after administration of pro- tamine(P<0.05).The IgM is decre- ased at 10 rain and 30 rain after CPB than the control(P<0.05 and P<0.01 respectively),while the IgG and IgA showed no significant differenes from the preoperative levels.No leukopenia were observed during CPB.The rapid activa- tion of complements during CPB mainly acted through its alterative pathway wh- ereas these at the end of CPB and aft- er administration of protamine are thr- ough both classic and alterative path- ways.