体外循环心内直视手术对外周血淋巴细胞表面肾上腺素能β受体-腺苷酸环化酶系统的影响

Effect of Cardiopulmonary Bypass on Adrenergic Beta Receptor-Adenylate Cyclase System of Peripheral Lymphocytes Surfaces

选择40例择期体外循环心内直视术患者,动态监测其围术期间外周血淋巴细胞内cAMP/cGMP比值变化,以探讨心内直视术对患者外周血淋巴细胞膜肾上腺素能β受体-腺苷酸环化酶系统的影响,并讨论其意义。结果发现麻醉后、术毕及术后2周内淋巴细胞内cAMP水平及cAMP/cGMP比值均显著低于麻醉前对照水平,同时发现淋巴细胞白介素-2受体表达及白介素-2诱生水平亦明显降低,术后严重感染率达33％。本文结果提示心内直视术可导致外周血淋巴细胞膜肾上腺素能β受体-腺苷酸环化酶系统损伤,这是导致严重细胞免疫功能障碍的重要因素之一。

To investigate the influence of cardiopulmonary bypass (CPB) on adrenergic beta receptor-adenylate cyclase system of peripheral lymphocytes, 40 patients, aged 15 ±10 years, underwent selective operation with CPB were studied by measuring intracellular levels of cAMP.cGMP of peripheral blood lymphocytes after anesthesia,right after CPB.and on 1st,7th,14th day postoperatively. The results demonstrate that intracellular concentration of cAMP was significantly lower than that after anesthesia,right after CPB,and during the first two postoperative weeks as compared with preanesthesia level. The ratio of cAMP/cGMP was markedly reduced. The data suggest that operative procedure with CPB can cause serious damage to adrenergic beta receptor-adenylate cyclase system of circulating lymphocytes surfaces, which might be one of the mechanisms resulting in immunosuppression after CPB.