CAJ | 학술논문

肺损伤为体外循环术后常见的并发症之一，血液与体外循环管道接触，能够活化补体、激活白细胞；白细胞激活后黏附于血管内皮细胞或进入肺组织，释放具有趋化作用的炎性介质及代谢产物，如蛋白酶、氧自由基和花生四烯酸等在肺损伤中起着重要作用。动物实验及临床应用白细胞过滤器在体外循环中对白细胞进行过滤，肺血管阻力明显降低，血氧饱和度、动脉血氧分压升高，尤其对术前缺氧越重和体外循环时间越长的患者作用越明显。因此，在体外循环中进行白细胞过滤能够减轻其对肺的损伤，起到肺保护作用。
폐손상위체외순배술후상견적병발증지일，혈액여체외순배관도접촉，능구활화보체、격활백세포；백세포격활후점부우혈관내피세포혹진입폐조직，석방구유추화작용적염성개질급대사산물，여단백매、양자유기화화생사희산등재폐손상중기착중요작용。동물실험급림상응용백세포과려기재체외순배중대백세포진행과려，폐혈관조력명현강저，혈양포화도、동맥혈양분압승고，우기대술전결양월중화체외순배시간월장적환자작용월명현。인차，재체외순배중진행백세포과려능구감경기대폐적손상，기도폐보호작용。
Lung injury was one of the most complications after extracorporeal circulation. As a result of blood exposure to the surface of the extracorporeal circulation circuit, the complements and leukocytes were activated. The activated neutrophil adhered to endothelial cells and released many inflammatory mediators, as protease, oxygen free radicals, arachidonic acid metabolites. All of these inflammatory mediators caused lung injury. In vivo and in vitro, many studies demonstrated that leukocyte depletion in extracorporeal circulation of heart operation could reduce lung injury and improve lung function. Leukocyte depletion could reduce pulmonary resistance, particularly effective in patients with a low preoperative oxygenation capacity and in those for whom an extended period of extracorporeal circulation was required.