CAJ | 학술논문

目的：观察体外循环（CPB）后外周血中性粒细胞膜碱性磷酸酶（NAP）表达的变化规律以及与白细胞（WBC）计数、C反应蛋白（CRP）水平之间的关系。方法选择连云港市第一人民医院心脏外科CPB心脏手术患者20例为研究对象，分别于术前、术后即刻0 h、术后24 h、术后48 h、术后72 h、出院时留取血标本，应用血细胞分析仪进行白细胞计数、免疫比浊法检测CRP浓度、流式细胞术定量检测NAP表达。结果 NAP表达和CRP浓度在CPB术后0 h显著下降，随后显著升高，48 h达到高峰，72 h开始下降，出院时恢复术前水平。相关分析结果表明，NAP的表达与血清CRP呈正相关，r为0.957（P＜0.001），高于与WBC计数相关性，r为0.608（P＜0.01）。结论 CPB后NAP表达显著升高，其变化规律与血清CRP基本一致，可以作为CPB下全身炎症反应严重程度的一个预警指标，长时间的NAP升高可能预示着机体存在炎症。
목적：관찰체외순배（CPB）후외주혈중성립세포막감성린산매（NAP）표체적변화규률이급여백세포（WBC）계수、C반응단백（CRP）수평지간적관계。방법선택련운항시제일인민의원심장외과CPB심장수술환자20례위연구대상，분별우술전、술후즉각0 h、술후24 h、술후48 h、술후72 h、출원시류취혈표본，응용혈세포분석의진행백세포계수、면역비탁법검측CRP농도、류식세포술정량검측NAP표체。결과 NAP표체화CRP농도재CPB술후0 h현저하강，수후현저승고，48 h체도고봉，72 h개시하강，출원시회복술전수평。상관분석결과표명，NAP적표체여혈청CRP정정상관，r위0.957（P＜0.001），고우여WBC계수상관성，r위0.608（P＜0.01）。결론 CPB후NAP표체현저승고，기변화규률여혈청CRP기본일치，가이작위CPB하전신염증반응엄중정도적일개예경지표，장시간적NAP승고가능예시착궤체존재염증。
Objective To examine the kinetics of expression of alkaline phosphatase on the surface membrane of neutrophils(NAP) in peripheral blood of patients undergoing cardiopulmonary bypass (CPB) and to study the correlation of changes of NAP, leukocyte (WBC) count and C-reactive protein (CRP). Methods The subjects included 20 patients who underwent cardiac surgery with CPB. Blood samples were collected at the time of before CPB(baseline), immediately after CPB(0 h), 24 h, 48 h, 72 h postoperatively and discharge.WBC counts by hematology analyzer, CRP levels by immunoturbidimetry assay and NAP by flow cytometry were evaluated. Results After operation, the expression of NAP and the CRP levels decreased significantly at 0 h, then increased and reached the peak at 48 h, but began to decline at 72 h, and recovered to the baseline levels at the time of discharge. Correlation analysis showed that NAP was positively correlated with serum CRP(r=0.957, P<0.001) and the WBC counts (r=0.608, P<0.01). Conclusions The expression of NAP was significantly increased after CPB and consistent basically with the changes of serum CRP. The increase of NAP for a long time may indicate the presence of inflammatory in vivo. The expression of NAP may be used as a new inflammatory marker clinically.