体外循環における末梢白血球に関する研究

The both qualitive and quantitative changes of leucocytes were seen during extracorporeal circulation. White blood cell count gradually decreased on starting the extracorporeal circulation. Hemogram showed the neutrophilia with the nuclear shift to the left, and appearance of the immature bone marrow cell in peripheral blood. Adhesive property of leucocyte markedly disturbed, ameboid motility and phagocytic property of neutrophiles were impaired, also. Considering the effect to leucocyte during the extracorporeal circulation, there are three factors, that is heparin, mechanical acting of heart-lung machine and massive transfusion. Heparin made peripheral leucocyte count decreased and adhesive property impaired. Heart-lung machine destroyed the leucocyte. Massive transfusion decrease the white blood cell count by means of dilution. And both impaired adhesive property, phagocytic property and ameboid motility. Clinically, using agglutination test and antihumanglobulin consumption test, leucocyte antibody were examined in 30 cases performed extracorporeal circulation and 20 cases with preserved blood transfusion in general surgery. Complete antibody was seen in one case (3.3%). incomplete antibody was in 8 cases (26.7%) with extracorporeal circulation. In 2 cases with preserved blood transfusion (10%) incomplete antibody was also seen. Those revealed one massive transfusion might produce the leucocyte antibody. The effect to blood coagulation of white blood cell or homogenized white blood cell, which were separated after extracorporeal circulation, were experimentally studied. White blood cell depressed the 1st phase of blood coagulation, and homogenized cell depressed the 1st and 2nd phase. Both two promoted the fibrinolysis. Homogenized white blood cell dissolved the fibrin plate, that were not inhibited with antiplasmin agent. These suggest any proteolytic enzyme except plasmin are acting in concert with activator and / or streptokinase-like substance. Inhibitory property of blood serum to fibrinolytic activity of leucocyte was reduced after extracorporeal circulation.

学位番号 乙第210号