Phosphorylcholine coating of bypass systems used for young infants does not attenuate the inflammatory response.
Phosphorylcholine coating of bypass systems used for young infants does not attenuate the inflammatory response.
复制标题
用于小婴儿的旁路系统的磷酰胆碱涂层不会减弱炎症反应。
DOI：
10.1016/j.athoracsur.2005.11.058
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
R. Dion
中科院分区：
文献类型：
--
作者：
A. M. Draaisma;M. Hazekamp;Nanning Anes;P. Schoof;C. Hack;A. Sturk;R. Dion
血液与体外循环（CPB）系统的人工表面接触被认为是补体激活的主要原因。通过减少血液元素的接触活化来改善系统的生物相容性，从而产生更少的炎症反应显然是需要的，特别是对于更容易受到CPB有害影响的新生儿和婴儿。一种名为Phisio的磷胆碱涂层被设计用来模拟血液的自然界面。本研究的目的是比较磷胆碱包被CPB系统与未包被CPB系统对补体激活和临床结果的影响。方法本研究为前瞻性、随机、盲、单中心研究，将28例体重3 ~ 6 kg的新生儿及新生儿体外循环患者分为两组，分别为磷胆碱组和对照组。13例患者被分配到磷胆碱组，15例患者被分配到对照组。排除唐氏综合征、早产、紫绀或再手术患者。测定补体因子C3b/c、人中性粒细胞弹性酶（HNE）、白细胞介素-6和c反应蛋白。重症监护时间、通气时间、最高体温和肌力药物是临床变量。结果CPB前后补体因子C3b/c、HNE、白细胞介素-6、c反应蛋白水平各组间无显著差异。两组间无临床差异。结论在新生儿和婴儿CPB过程中，磷酸胆碱包覆不会减弱补体活化。
BACKGROUNDContact of blood with the artificial surfaces of the cardiopulmonary bypass (CPB) system is considered to be a main cause of complement activation. Improving the biocompatibility of the system by reduction of contact activation of blood elements and thereby producing less inflammatory response is evidently desired, especially for neonates and infants who are more susceptible to the deleterious effects of CPB. A phosphorylcholine coating, Phisio, is designed to mimic the natural interfaces of blood. The aim of this study is to compare the influence of a phosphorylcholine-coated CPB system versus an uncoated CPB system on complement activation and clinical outcomes.METHODSIn this prospective, randomized, blind, one-center study, 28 neonates and infants with a bodyweight between 3 and 6 kg who were undergoing cardiopulmonary bypass were divided in two groups, the phosphorylcholine group and the control group. Thirteen patients were assigned to the phosphorylcholine group and 15 patients to the control group. Patients with Down syndrome, prematurity, cyanosis, or reoperation were excluded. Complement factor C3b/c, human neutrophil elastase (HNE), interleukin-6, and C-reactive protein were measured before, during, and after CPB. Duration of intensive care stay, ventilation time, highest body temperature, and inotropic medication were the clinical variables.RESULTSNo significant differences were found between the groups for complement factor C3b/c, HNE, interleukin-6, or C-reactive protein during and after CPB. No clinical differences were observed between the groups.CONCLUSIONSPhosphorylcholine coating does not attenuate the complement activation during CPB in neonates and infants.