补体在严重骨折病人中性粒细胞杀菌功能降低中的作用

从多处和一处骨折的４１例病人随机采集６８份静脉血，观测分离的中性粒细胞（ＰＭＮ）胞内超氧离子、特殊颗粒（ＳＧ）和胞内杀菌力（ＩＣＢＡ）的水平；观察严重骨折病人血浆对正常人ＰＭＮ胞内、ＳＧ和ＩＣＢＡ的影响以及抗人Ｃ３Ｃ５血清（ＡＨＣ３Ｃ５Ｓ）对上述血浆有害作用的特异阻断效能。结果表明：（１）骨折病人ＰＭＮ的各指标值均低于正常水平，伤后１～４ｄＩＣＢＡ测值最低。（２）ＩＣＢＡ与和ＳＧ的测值相关显著（Ｐ＜０．０５）。（３）病人血浆能显著削减正常人ＰＭＮ胞内ＩＣＢＡ、和ＳＧ的储存，而ＡＨＣ３Ｃ５Ｓ能减轻这些储存的丢失，其净保留率排序为：（７０．７１％）、ＩＣＢＡ（５３．３０％）、ＳＧ（４１．１２％）。结果提示：Ｃ３Ｃ５碎片是ＰＭＮＩＣＢＡ下降的重要直接动因。其机理可能是Ｃ３ｂＣ５ａ对ＰＭＮ的持续作用，使胞内杀菌物质、ＳＧ在吞入病菌前就已消耗殆尽。这对骨折并发全身感染的防治有参考价值。

The role of complement in the decrease of intracellular bactericidal activity of polymorphonuclear neutrophils in patients with severe fracture

Sixty-eight samples of venous blood were collected from 41 patients with either single or multiple fracture and the level of intracellular bactericidal activity(ICBA),superoxide free ions)and specific granules(SG)in the isolated polymorphonuclear neutrophils(PMNs)were determined.The effects of the plasm from patients with bone fracture on the ICBA,and SG of normal PMNs and the specific blocking efficiency of anti-human C3C5 serum(AHC3C5S)on the harmful plasma of patients with bone fracture were studied in vitro.The findings were as follows:(1)The level of ICBA,and SG was lower in the bonefracture patients than in the normal(P<0.05)on the lst to 10th day after fracture and the level was the lowest on the lst to 4th day after fracture.(2) The level of ICBA was significantly correlated to that of and SG.(3) The patient's plasma markedly reduced the reserve of ICBA, and SG in the normal PMNs while AHC3C5S could partially ameliorate the reduction of the reserve of ICBA by 53. 30%, by 70.71% and SG by 41.12%. These findings suggest that the fragments of C3 and C5 are the direct factors to decrease ICBA of PMNs. Persistent action of C3 and C5 fragments might result in the escaping of the hactericidal and SG from the cells responsible for the phagocytosis of pathogens.Our findings may be useful in the prevention and treatment of the complicating systemic infections in patients with bone fracture.