摘要
目的研究体外循环期间七氟醚全程吸入对肺内炎症反应的影响。方法 30例患者随机分为七氟醚组(S组,n=15)、丙泊酚对照组(P组,n=15)。分别于麻醉诱导前、心肺转流(CPB)前、复跳后10 min、CPB后2 h、CPB后24 h测桡动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)和吸入氧浓度(Fi O2),评估氧合指数(OI)和呼吸指数(RI);通过检测血中中性粒细胞、白细胞、淋巴细胞数量、白介素-6(IL-6)的浓度及其在肺静脉和肺动脉的比值(PV/PA),评估肺内炎症情况。结果与对照组比较,七氟醚组炎症细胞数量在各时间点的PA和PV中较低,且白细胞、中性粒细胞的PV/PA较高,淋巴细胞的比值无差别,IL-6的PV/PA较低;虽然2组肺功能均下降,但七氟醚组肺功能指标较优。结论相比丙泊酚,七氟醚能抑制肺内炎症细胞聚集,减轻炎症反应,改善肺功能。
Objective To observe the effect of sevoflurane on pulmonary inflammatory responses during cardiopulmonary bypass surgery. Methods Thirty patients undergoing mitral and aortic valve replacement surgery were randomly divided into an experimental group（sevoflurane group S, n = 15） and a control group（propofol group P, n = 15）. Before the anesthesia, before the CPB, 10 minutes after the restoration of heart beats, 2 hours after the CPB and 24 hours after the CPB, the arterial oxygen tension（Pa O2）, arterial carbon dioxide tension（Pa CO2）, and inspired oxygen concentration（Fi O2） were measured to assess the oxygenation index（OI） and respiratory index（RI）. To assess the inflammatory situation of the lung, the leukocyte counts（WBC）, neutrophil count s（N）, lymphocyte counts（L） and interleukin-6（IL-6） levels in the plasma were measured, and the PV/PA ratio of these inflammatory indexes was observed. Results The inflammatory index counts in PA and PV of groug P at any time were lower than those of group S： the PV/PA ratio of WBC and N was higher, while the PV/PA ratio of N was unchanged, and the PV/PA ratio of IL-6 was lower. The pulmonary function in the 2 groups was deteriorated gradually： the RI went up while the OI descended. Both RI and OI in group S at any time were superior. Conclusion Sevoflurane can suppress the pulmonary sequestration of inflammatory cells and attenuate the pulmonary inflammatory responses during cardiopulmonary bypass surgery. Sevoflura ne improves the oxygenation and attenuates the postoperative pulmonary complications.
出处
《中南药学》
CAS
2016年第7期700-703,共4页
Central South Pharmacy
关键词
七氟醚
体外循环
炎症反应
缺血再灌注损伤
肺损伤
双瓣置换术
sevoflurane
cardiopulmonary bypass
inflammatory response
ischemia-reperfusion injury
lung injury
double valve replacer
