Alterations in the number of circulating leucocytes, phenotype of monocyte and cytokine production in patients undergoing cardiothoracic surgery
Alterations in the number of circulating leucocytes, phenotype of monocyte and cytokine production in patients undergoing cardiothoracic surgery
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DOI：
10.1046/j.1365-2249.1999.00801.x
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发表时间：
1999-02-01
影响因子：
4.6
通讯作者：
Roth, E
中科院分区：
文献类型：
--
作者：
Hiesmayr, MJ;Spittler, A;Roth, E
对 7 名接受心脏手术/心肺旁路 (CPB) 患者和 9 名接受胸外科/未 CPB 患者组成的组进行了血细胞分类计数、单核细胞表型和细胞因子血浆水平的变化评估，这两名患者均接受相同的基于阿片类药物的麻醉技术。麻醉和手术后观察到循环淋巴细胞和单核细胞数量显着减少。有趣的是，在手术结束时以及手术后 1 天，粒细胞数量明显增加。全身麻醉和手术导致 HLA-DR 和 CD11c/CD18 分子显着减少（在麻醉诱导后立即开始），并在麻醉后第 1 天导致 CD64 增加。使用 CPB 后，手术结束时 CD32、CD16、CD54 和 HLA-ABC 抗原表达显着降低。手术一天后，除 CD54 外，这些参数几乎恢复到基线值。两组在每个时间点均发现以低CD14、高CD16和HLA-DR表达（CD14（+）CD16（+）HLA-DR++）为特征的单核细胞亚群，并且该细胞亚群的百分比从基线到24小时有所下降。 CPB 期间 IL-6 和 IL-10 的血浆浓度显着增加。未发现手术或体外循环导致IL-1水平的动态变化。我们得出的结论是，麻醉以及体外循环的使用引起了循环白细胞数量、单核细胞表型和细胞因子产生的深刻变化。
Changes in the differential blood cell count, monocyte phenotype and the cytokine plasma levels in a group of seven patients with cardiac surgery/cardiopulmonary bypass (CPB) and nine patients with thoracic surgery/without CPB, both receiving identical opioid-based anaesthetic technique, were assessed. A significant reduction in the number of circulating lymphocytes and monocytes was observed after anaesthesia and surgery. Interestingly, at the end of surgery as well as 1 day post-surgery a marked increase in the number of granulocytes was noted. General anaesthesia and surgery caused a significant reduction of HLA-DR and CD11c/CD18 molecules, starting immediately after induction of anaesthesia, and an increase of CD64 at day 1 after anaesthesia. The use of a CPB was followed by a significant reduction of CD32, CD16, CD54 and HLA-ABC antigens expression at the end of surgery. One day after surgery these parameters returned nearly to baseline values with the exception of CD54. A monocyte subpopulation, characterized by low CD14, high CD16 and HLA-DR expression (CD14(+)CD16(+)HLA-DR++) was found in both groups at each time point, and the percentage of this cell subset decreased from baseline to 24 h. The plasma concentrations of IL-6 and IL-10 increased considerably during CPB. No dynamic changes of IL-1 level due to surgery or CPB were found. We conclude that anaesthesia as well as the use of CPB induced profound alterations in the number of circulating leucocytes, and in the phenotype of monocyte and cytokine production.