摘要
目的观察乌司他丁在体外循环心内直视手术中对炎性细胞因子水平的影响。方法30例体外循环心内直视手术患者随机分为乌司他丁组(U)和对照组(C),每组各15例。乌司他丁组(U)总量给予乌司他丁12 000 IU/kg,分别在体外循环前静脉滴入半量,体外循环机内加入半量。对照组(C)用等量的生理盐水。分别在切皮前(T1)、体外循环开始后30 min(T2)、体外循环停止(T3)、体外循环结束后2h(T4)、体外循环结束后4h(T5)、体外循环结束后24 h(T6)采集血标本,测定血清中的肿瘤坏死因子(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)。结果两组T2、T3、T4、T5、T6各时间点TNF-α、IL-2、IL-6、IL-8、IL-10均明显高于T1(P<0.01或P<0.05),而U组TNF-α、IL-2、IL-6、IL-8明显低于C组(P<0.01或P<0.05),IL-10均明显高于C组(P<0.01或P<0.05)。结论体外循环导致白细胞激活,大量炎性介质释放和自由基产生,激发全身炎症反应综合症。乌司他丁应用于体外循环心内直视手术中可以减少TNF-α、IL-2、IL-6、IL-8的释放,促进抑炎细胞因子IL-10的分泌,从而减轻有效地降低由于CPB引发的炎症反应,减轻心肌的缺血再灌注损伤,起到保护心肌的作用。
Objective To observe effects of ulinastation on inflammatory factors during CPB for open - heart surgery. Methods 30 patients scheduled for selective cardiopulmonary bypass （CPB） for open - heart surgery were randomly divided into two groups ： ulinastation group （U） and control group （ C）, 15 cases in each group. Ulinastation group （U） total quantity to give ulinastation 12 000 IU/kg. Half quantity is dripped into the vein before the external circulation, and the external circulation within the aircraft respectively. Control group （C） uses the isometric the physiological saline. Gather blood specimen at such times as before the skin is cut （T1 ）, 30 rain after the external circulation starts （T2 ）, when the external circulation stops （ T3 ）, 2 h after the external circulation finishes （T4）, 4 h after the external circulation ends （T5）, 24 h after the external circulation ends （T6）, and determine blood serum tumor necrosis factor （TNF-α）, iuterleukin - 2 （IL-2）, interleukin - 6 （IL-6）, interleukin - 8 （IL-8）, and interleukin - 10 （ IL - 10）. Results Two groups of T2, T3, T4, T5, the T6 various time select TNF - ct, IL - 2, IL - 6, IL - 8, IL - I0 are obviously higher than T1 （ P 〈 0. 01 or P 〈 0. 05 ）, but U group of TNF - α, IL - 2, IL - 6, IL - 8 are lower than C group （ P 〈 0. 01 or P 〈 0. 05）. IL - 10 is obviously higher than C group （P 〈 0. 01 or P 〈 0. 05）. Conclusions External circulation causes the activation of white blood cell, the massive inflammatory medium release, the free radical production, and the whole body inflammation response syndrome. Ulinastation to apply in vitro follows in the crown of arch to look straight ahead in the surgery to be possible to reduce TNF -α, IL -2, IL -6, the IL -8 release, promotes to damp phlogecyte factor IL - 10 the secretion, thus reduces effectively the CPB initiation inflAmmAtion response, reduces cardiac and pulmonary injury induced by lower extremity ischaemia reperfusio
出处
《辽宁医学院学报》
CAS
2009年第2期152-154,共3页
Journal of Liaoning Medical University (LNMU) Bimonthly
关键词
乌司他丁
体外循环
炎性细胞因子
ulinastation
cardiopulmonary bypass （CPB）
inflammatory factor
