摘要
目的:观察异丙酚对婴幼儿体外循环心脏手术血细胞因子、心肌核转录因子(NF)-κB)和细胞间粘附分子(ICAM)-1表达的影响并试图说明其临床意义。方法:20例年龄1～9岁的先天性心脏病体外循环下行房、室间隔缺损矫正术的患儿,随机分为对照组(Ⅰ组,10例)和异丙酚麻醉组(Ⅱ组,10例)。麻醉诱导:咪唑安定,芬太尼,泮库溴铵。麻醉维持:I组,吸入0.25%～2%安氟醚,Ⅱ组,持续输注异丙酚15～20mg/kg.h。两组分别于全麻诱导气管插管和动静脉穿刺完成后稳定10min(T0),体外循环前(T1)、主动脉阻断25min(T2)、主动脉开放后30min(T3)、停止体外循环2h(T4)采集血液标本检测肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6。右房插管和缺血再灌注30min取右房心耳组织标本,观察NF-κB和ICAM-1的表达。结果:两组患儿TNF-α在术中和术后无显著差异,IL-6于术中和术后均升高,且I组的明显高于Ⅱ组(P<0.05)。再灌注30min后I组心肌组织NF-κB和ICAM-1的表达明显高于Ⅱ组(P<0.05)。结论:婴幼儿体外循环心脏手术期间,全身炎症反应被激活,心肌细胞NF-κB和ICAM-1过度表达;异丙酚能减轻其炎症反应,抑制心肌NF-κB和ICAM-1的表达。
Objective： To investigate the effect of propofol on myocardial nuclear factor-Kappa B （NF-κB） , intercellular adhesion molecule 1 （ICAM-1）, serum TNF-α and IL-6 in children with cardiopulmonary bypass （CPB） heart surgery. Methods： The 20 children withcongenital heart disease （ASD, VSD） and elective CPB heart surgery were divided into control group （n= 10） and propofol anesthesia group （n= 10） randomly. The myocardial samples were taken at the time of intubatton pre- CPB and reperfusion 30min to observe the variation of NF-κB, ICAM- 1. The serum TNF-α, IL-6 activity were examined at six different points. Results： There were no differents in TNF-α between two group, but IL-6 was much more in control group after CPB than that in propofol group （P〈0.05） after surgery . Myocardium NF-κB and ICAM- 1 significantly increased in control group at the time of reperfusion 30 min as compared with that of propofol group （P〈0.05）. Conclusion： Propofol can protect the myocardium against ischemia/reoerfusion injury through inhibition the activity of myocardium NF-κB and ICAM-1.
出处
《心血管康复医学杂志》
CAS
2009年第4期367-369,F0003,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
