摘要
目的:探讨乌司他丁对非体外循环冠脉搭桥手术(OPCAB)围术期炎症反应的影响。方法:择期行OPCAB患者42倒,随机分为对照组(C组,n=21)和乌司他丁组(U组,n=21)。U组于手术开始前静脉输乌司他丁1.5×104U/kg,C组于相同时间静脉输注同等剂量生理盐水。分别于麻醉诱导前(T1)、冠脉搭桥成功时(T2)、手术后lh(T3)和手术后24 h(T4)检测血浆肿瘤坏死因子(TNF-α)、白细胞介素(IL)-6、IL-10和中性粒细胞弹性蛋白酶(NE)的浓度。比较两组患者手术后的恢复情况。结果:与T1相比,两组患者在T2,T3,T4时TNF-a,IL-6,IL-10及NE的浓度均明显升高(P<0.05);U组在T2,T3,T4的TNF-α,IL-6及NE浓度均明显低于C组(P<0.05),而IL-10的浓度明显高于C组(P<0.05)。U组患者术后肺、肾及脑功能明显优于C组(P<0.05),心、肝功能及ICU停留时间无明显差异(P>0.05)。结论:乌司他丁能够减轻非体外循环冠脉搭桥手术围术期炎症反应,减少术后并发症。
Objective：To determine the effect of ulinastatin on perioperative inflammatory response to the off-pump coronary artery bypass surgery（OPCAB）. Methods： Forty patients undergoing CABG with OPCAB were randomly divided into 2 groups：a ulinastatin group（1.5 × 104 U/kg ）before anaesthesia n = 20）and a con- trol group（ n = 20）. The inflammatory cytokines such as tumor necrosis factor - a（TNF -a）, interleukin（IL） - 6, IL- 10 and neutrophil elastase（NE）were measured before the anesthesia（T1）, coronary artery bypass surgery （T2）, 1 h after coronary artery bypass surgery （T3）, and 24h after coronary artery bypass surgery （T4）. The postoperative organ dysfunction in the 2 groups was noted. Results： The concentration of TNF- a, IL - 6, IL- 10, and NE at T2, T3, and T4 increased more significantly than that at T1 in the 2 groups（P 〈 0.05）. The con- centration of TNF- a, IL - 6 and NE at T2, T3, and T4 in the ulinastatin group decreased mole significantly than that in the control group（P〈 0.05）, and ]L- 10 in the ulinastatin group increased at the same time. The postoperative complications of pneumonia, kidney and central nervous system in the ulinastatin group decreased more significantly than that in the control group（ P 〈 0.05）. There was no significant difference in the postoper- ative cardio or liver complications and hours in the ICU between the 2 groups. Conclusion： Administration of uli- nastatin before anesthesia can decrease the inflammatory response and complication during OPCAB.
出处
《内蒙古医学杂志》
2013年第3期283-285,共3页
Inner Mongolia Medical Journal
关键词
炎症反应
乌司他丁
冠状动脉旁路移植术
Inflammatory response
Ulinastatin
Coronary artery bypass Grafting
