围体外循环期白细胞肺内隔离的临床观察

Clinical study of Trans-pulmonary difference of leukocyte during the cardiopulnonary bypass

目的 研究围体外循环期白细胞各子集在肺内隔离的异同。方法 2 0例非紫绀型先天性心脏病患者于CPB前 ,主动脉开放后 ,1,5 ,10分钟及停CPB后 5分钟。分别经主肺动脉 ,右上肺静脉采血 2毫升。进行白细胞计数及中性粒细胞 ,淋巴细胞 ,单核细胞分类测定。结果 主动脉开放后 1,5 ,10分钟 ,肺循环动脉血白细胞计数及中性粒细胞计数显著低于静脉血 ;主动脉开放后 5分钟 ,肺循环动脉血淋巴细胞计数显著低于静脉血。其余各时点 ,各子集肺循环动 ,静脉血无差异。结论 体外循环再灌注早期存在白细胞肺内隔离现象 ,且各子集隔离现象存在差异。

Objective To investigate the trans-pulmonary difference of leukocytes(WBC)and leukocyts subsets during cardiopulmonary bypass(CPB). Methods In twenty patients with non-cyanotic congenital heart disease undergoing open heart surgery,blood is simultaneously drawn from trunk of pulmonary artery and right superior pulmonary vein at five different time intervals.The counts for leukocytes and leukocyte subsets polymorphonuclear neutrophils(PMN),lymphocytes(LYMP)and monocytes(MON)are quantitatively determined. Results The counts for leukocytes and polymorphonuclear neutrophils in pulmonary vein are significantly lower than that of pulmonary artery at 1 min,5 min 10 min after aorta declampin.The count for lymphocytes in pulmonary vein is significantly lower than that of pulmonary artery at 5 min after aorta declamping.And monocytes has no trans-pulmonary difference during cardipulmonary bypass. Conclusion There are trans-pulmonary difference of leukocytes and leukocyte subsets during early reperfusion of lungs.