对体外循环术中补体系统激活的观察

本文对21例体外循环心内直视手术患者和9例闭式二尖瓣交界分离术患者术前、术中和术后血清总补体活性(CH_(50)),C_3和循环免疫复合物(CIC)进行测定。转流15分钟后血清CH_(50)和C_3明显降低。阻断主动脉、注射鱼精蛋白没有导致CH_(50)和C_3进一步降低。闭式二尖瓣交界分离组术后即刻以及术后24小时、48小时血清CH_(50)和C_3均无明显改变。体外循环组C_3术后24小时,CH_(50)术后48小时恢复术前水平。CIC在转流过程中以及术后无明显改变。经统计处理,CIC与CH_(50)和C_3之间无相关关系。提示转流术中血清CH_(50)和C_3降低不是由于形成抗原抗体复合物所致,而是激活消耗。

Observation of Complement Activation duringCardioplmonary Bypass

We studied 21 patients undergoing cardiopulmonary bypass for cardiac operation. CH_(50) and C_3 decreased rapidly within few minutes after starting cardiopulmonary bypass, indicating complement system activation. Aortic cross-clamping and protamine administration did not lead to further consumption of CH_(50) and C_3 by activation. CH_(50) and C_3 did not relate to CIC significantly. So, the consumption of complement seemed not due to the formation of immunity complex. C_3 returned to the levels prior to performing cardiopulmonary bypass 24 hours later and CH_(50) at 48 hours later. Slow and divided dosage of intravenous infusion of protamine sulfate after cardiopulmonary bypass to neutralized heparin seems to produce less influence in circulatory dynamics.