REDISTRIBUTION OF LYMPHOCYTES AFTER MAJOR SURGICAL STRESS
REDISTRIBUTION OF LYMPHOCYTES AFTER MAJOR SURGICAL STRESS
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DOI：
10.1111/j.1399-6576.1993.tb03708.x
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发表时间：
1993-04-01
影响因子：
2.1
通讯作者：
CHRISTENSEN, NJ
中科院分区：
文献类型：
--
作者：
TOFT, P;SVENDSEN, P;CHRISTENSEN, NJ
大手术引起内分泌应激反应，其特征是血清皮质醇、血浆肾上腺素和去甲肾上腺素增加。此外，手术应激伴随外周血中的淋巴细胞减少症和粒细胞增多症。外周白色血细胞的变化已在手术后以及皮质醇输注后得到证实。本研究的目的是调查大手术后外周血淋巴细胞重新分布到哪些组织/器官。从20只家兔的外周血中分离淋巴细胞，用~（111）铟-托泊烯标记，静脉注射给家兔。其中10只兔子在全身麻醉期间接受了大手术（上腹腔镜手术），而对照组（n = 10）在没有手术的情况下麻醉。以血清皮质醇、血浆肾上腺素和去甲肾上腺素作为内分泌应激反应的指标。在皮肤切开前、切开后2、4和7 h用γ照相机成像并用连接的计算机计算淋巴细胞的再分布。与术前值相比，剖腹手术导致血清皮质醇从116.6增加到461.9 nmol/l（平均值），外周血淋巴细胞的分数/百分比从43.8%减少到术后7 h的14.7%。同时，心肺活动共同下降至初始值的76.1%，而脾脏活动不受影响。手术开始后4和7 h，淋巴组织的放射性分别增加至137.8%和134.7%。结果表明，大手术诱导淋巴细胞从外周血到淋巴组织的重新分布。这表明，内分泌应激反应可能是非常重要的。
Major surgery evokes an endocrine stress response, characterized by increased serum cortisol, plasma adrenaline and noradrenaline. Furthermore, surgical stress is accompanied by lymphopenia and granulocytosis in peripheral blood. The changes in peripheral white blood cells have been demonstrated after surgery as well as after cortisol infusion. The aim of the present study was to investigate to which tissues/organs peripheral blood lymphocytes are redistributed after major surgery. From 20 rabbits lymphocytes were isolated from peripheral blood, labelled with indium-111-tropolene and reinjected intravenously into the rabbits. Ten of the rabbits underwent major surgery (upper laparatomy) during general anaesthesia, while the control group (n = 10) was anaesthetized without surgery. The endocrine stress response to surgery was measured as serum cortisol, plasma adrenaline and noradrenaline. The redistribution of lymphocytes was imaged with a gamma camera and calculated with a connected computer before, 2, 4 and 7 h after the skin incision. Compared to preoperative values, laparotomy resulted in an increase in serum cortisol from 116.6 to 461.9 nmol/l (mean) and a decrease in the fraction/percentage of lymphocytes in peripheral blood from 43.8% to 14.7% 7 h after surgery. Simultaneously, the activity of the heart and lungs together decreased to 76.1% of initial values, while the spleen activity was unaffected. The radioactivity of the lymphatic tissue increased to 137.8% and 134.7%, respectively, 4 and 7 h after the start of surgery. The results indicate that major surgery induces a redistribution of lymphocytes from peripheral blood to lymphatic tissue. It is suggested that the endocrine stress response may be of major importance.