The terminal complement complex (sC5b-9) is not specifically associated with the development of the adult respiratory distress syndrome.
The terminal complement complex (sC5b-9) is not specifically associated with the development of the adult respiratory distress syndrome.
复制标题
末端补体复合物 (sC5b-9) 与成人呼吸窘迫综合征的发生并无特定关联。
DOI：
10.1164/ajrccm/141.1.98
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Giclas,PC
中科院分区：
文献类型：
--
作者：
Parsons,PE;Giclas,PC
过去的研究表明，终末补体复合物（sCSb-9）的血浆I_Is增加是脓毒症患者发生成人呼吸窘迫综合征（ARDS）的早期标志。sCSb-9 W_（88）的升高是否也与其他病因所致的ARDS的发生有关，sCSb-9的升高是否一致地反映了体内补体的激活。我们评估了75例有脓毒症、创伤、输血过多、多发性骨折、误吸或胰腺炎的患者，这些患者有发生ARDS的风险，但没有消除该综合征，23例有类似病史的患者确实发生了ARDS。在后一种患者中，sevan _re识别并研究了他们何时处于危险中以及何时患有ARDS。获得系列血液样本，并分析补体激活产物Bb、Ba、C4 c1、C3 d、IC 3b和sCSb-9。除1例患者外，所有患者的一种或多种补体片段水平均高于18例正常人血清中的2SD。与之前提到的报告相反，没有测量到任何片段，包括sC 5 b-9、W88（ARDS的特异性IC指标），并且没有补体片段的组合预测哪些有风险的患者会患上ARDS。患者表现出仅经典途径、仅交替途径或两种途径激活的证据，但W88均未与疾病的更大风险或严重程度相关。此外，在一些患者中，只有少量的成分被激活，这表明除了来自补体激活的酶之外，其他酶也可能起作用。总之，在危重III型患者中，补体可通过多种机制激活。个体溢出产物和SCSb-9的测量均不能预测哪些患者会发展ARDS，哪些不会。AM修订版DIS 1990; 141：98-103
Prevlouslnvestlgatol'8 suggested that Increased plesma I_Is of the terminal complement complex (sCSb-9) are an early marklerfor the development of adult resplretory distress syndrome (ARDS) In septic patients. Weaskied whether an Increase In sCSb-9W88 also a880Clstedwith the d_lopment of ARDSfrom other etiologies and whether sCSb-9 meesurements consistently reflectad complement activation In~ Ivo. Weevaluatad 7Spatients with sepsis, trauma, hypertransfusion, multiple fractures, aspiration, or pancreatitis who _re at risk for ARDSbut did not dlMtlop the syndrome and 23 patients with similar histories who did develop ARDS. Of the latter patients, sevan _re Identified and studied both when they _re at risk and when they had ARDS. Serial blood samples were obtained and analyzed for the complement activation products Bb, Ba, C4c1, C3d, IC3b, and sCSb-9. All but one of the patients studied had levels of one or more complement fragments that _re greater than 2 SDabovathe meen obtained from 18normal sUbJects. In contrast to the report referred to previously, none of the fragments meesured, Including sC5b-9, W88 a specif-Ic Indicator of ARDS, and no combination of complement fragments predicted which patients at risk would d_lop ARDS. Patients demonstrated evidence of activation of the classical pathwey only, altematlva pathwey only, or both pathways, but none of thesa W88 esaoclated with greater risk or sevarlty of disease. In addition, In sevaral patients only Iete components _re activated, suggesting that enzymes other than those derived from complement activation mey be responsible. In conclusion, complement can be activated by a variety of mechanisms In critically III patients. The measurement of neither Individual spilt products nor SCSb-9 predicts which patients will devalop ARDSand which will not. AM REV RESPIR DIS1990; 141: 98-103