- 期刊
比較開心手術中補體活化因子C5a及過氧化氫濃度變化及相關性
The Correlation between the Concentration Change of Activated Complement C5a and Hydrogen Peroxide during Cardiopulmonary Bypass
摘要
人工心肺循環症候群的特徵包括微血管通透性升高，組織間液增加，白血球數目升高，發燒及肺臟、心臟、腎臟、肝臟、大腦等器官功能失調。而過多自由氧游離基之釋放及補體活化導致一連串免疫發炎反應，可能是引起上述人工心肺循環症候群的關鍵因素。本實驗目的乃在同一組接受心冠狀動脈繞道手術病人，於人工心肺循環前後，分別偵測到補體活化因子C5a及活化性氧代謝物群中過氧化氫H2O2鈴血漿中濃度變化趨勢及其相關性，進而探討其鈴人工心肺循環症候群中所扮演的角色。 本實驗共收集22位接受常規心冠狀動脈燒道手術的病人，在手術特定時閒，經橈動脈抽取血液標本，置於EDTA試管內，於攝氏4℃低溫下以每分鐘3000轉速離心20分鐘後，將血漿分置於兩根試管，置於零下70℃冰凍保存，分別作補體活化因子C5a（利用Radio－immunoassay方式測定）及過氧化氫H2O2（Horse－radish Per一oxidase一Coupled Oxidations法）之分析 C5a於體外循環進行時濃度最高，H2O2濃度則於體外循環結束時才開始增高。我們推測C5a乃因人工心肺循環而活化，H2O2則因缺血後再灌流而增加。
並列摘要
Cardiopulmonary bypass (CPB) has been found to be associated with a wide variety of early postoperative physiological and immune derangements, including an observed increase in capillary permeability, and interstitial fluid, mild fever, leukocytosis, bleeding diatheses, and hepatic, cardiac, pulmonary and renal dysfunction with a wide spectrum of severity. The pathogenesis of these changes is complex and is thought to depend in part on complement activation and release of reacted oxygen metabolites, causing a series of systemic inflammatory responses. In this study, we compared the changes of complement activation and the concentration of H2O2 (hydrogen peroxide) during open heart surgery under CPB try to identify their correlation and role in postpump syndrome. Twenty two patients undergoing elective coronary artery bypass graft surgery were studied. Blood was sampled from the radial artery at different stages of each procedure and centrifuged at 4℃, 3000 rpm for 20 minutes. Plasma was transferred to 2 tubes and stored at -70℃ pending detection of C5a (Radioimmunoassay method) and of H2O2 (Horseradish per-oxidase-coupled oxidation method) respectively. Plasma C5a level was at its highest 30 min after CPB, whereas H2O2 level began to rise after termination of CPB. We speculate that complement activation may originate from the effects of extracorporeal circulation and H2O2 from postischemic reperfusion.