摘要
目的 :探讨前列腺素 E1(PGE1)在风湿性心脏病二尖瓣置换术中对细胞因子 IL- 6 ,IL- 8,IL- 10的影响及对缺血再灌注心肌的保护作用和机制。方法 :收治 30例单纯风湿性心脏病二尖瓣膜病变且需在体外循环下行二尖瓣置换术的患者 ,随机分为 PGE1组 (经静脉内滴注 L ipo- PGE10 .0 4 pg.kg-1.min-1,从手术开始直到结束 ,n=15 )和对照组 (未应用 PGE1,n=15 )。通过测定围手术期 5个时间点血清细胞因子 (IL- 6、IL- 8、IL- 10 )和 CK- MB及心肌肌钙蛋白 T(c Tn- T)的水平 ,研究细胞因子 (IL - 6、IL - 8、IL - 10 )和 CK- MB及 c Tn- T的变化情况与 PGE1对细胞因子和再灌注心肌的影响。结果 :两组患者的血清 IL - 6、IL- 8、CK- MB和 c Tn- T水平在升主动脉开放后均有明显升高 ,尤其在主动脉开放后 2 h,但对照组明显高于 PGE1组 P<0 .0 5 ;血清 IL - 10水平也明显升高 ,但两组比较无明显差别 ,P>0 .0 5。IL- 6、IL- 8水平和 CK- MB水平相关 (r2 =0 .4 0 ,r2 =0 .38;P>0 .0 5 )。IL- 6、IL- 8水平和 c Tn- T水平相关 (r2 =0 .5 6 ,r2 =0 .14 ;P>0 .0 5 )。结论 :在风湿性心脏病二尖瓣置换术中 ,PGE1通过抑制 IL- 6、IL- 8的释放 ,下调促炎因子 /抗炎因子间的平衡 。
Objective: To investigate the effects of prostaglandin E1 (PGE1) on the cytokines (IL-6,IL-8,IL(-10)) levels and ischemic-reperfusion injury of myocardium during cardiac surgery. Methods: A total of 30 patients undergoing cardiac surgery (mitral valve replacement) under extracorporeal circulation were randomized into two groups: PGE1 group (receiving 0.04 mμg.kg^(-1).min^(-1) of Lipo-PGE1 from the beginning of surgery to the end of study,n=15) and control group (no PGE1 given,n=15). Levels of serum IL-6,IL-8 and IL-10 were measured by enzyme-linked immunosorbent assays (ELISA). Isoenzyme of creatine kinase with muscle and brain subunits(CK(-MB)) and troponin-T (cTn-T) were measured by ultraviolet absorption spectrophotometry method and enzyme immunoassay on 5 time-points during the study. Results: In both groups serum IL-6,IL-8,CK-MB and cTn-T levels increased significantly after aorta declamping (especially from 2 h after aorta declamping) compared with preoperative levels (P<0.05).However,the elevations of these cytokines and enzymes were more prominent in the control group than in the PGE1 group (P<0.05). Serum IL-10 concentration increased significantly from 2 h after aorta declamping compared with preoperative value (P<0.05);but there were no differences between the two groups. IL-6 and IL-8 levels were correlated with CK-MB and cTn-T concentrations(r^2=0.40, r^2=0.38;P>0.05 and (r^2=0.56),r^2=0.14;P>0.05,respectively).Conclusion: During cardiac surgery (mitral valve replacement) PGE1 may suppressed the production of IL-6,IL-8 but not IL-10,which may be related to its myocardial protection (effect.)
出处
《浙江大学学报（医学版）》
CAS
CSCD
2004年第4期353-356,共4页
Journal of Zhejiang University(Medical Sciences)
