摘要
目的分析乌司他丁对心脏术后患儿炎症反应的影响和肺功能保护作用及其分子生物学机制。方法选择2018年1月至2021年7月收治的100例先天性心脏病患儿作为研究对象,采用随机数字表法将患儿分为两组,对照组(50例)予以常规治疗,研究组(50例)在对照组的基础上联合乌司他丁治疗,比较两组患儿的心肌酶、炎症反应、肺功能、免疫功能指标、中性粒细胞计数与CD11b活性,并记录两组患儿的并发症发生率。结果术后2 h、3 h,两组患儿的血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)较术毕即刻均明显升高,且对照组明显高于研究组(P<0.05);两组患儿的血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)较术毕即刻均明显升高,且对照组明显高于研究组(P<0.05);两组患儿的动脉血氧分压(PaO_(2))/吸入气氧分压(FiO_(2))、肺泡动脉氧分压差(P_((A-a))O_(2))较术毕即刻均明显改善,且对照组PaO_(2)/FiO_(2)明显低于研究组,P_((A-a))O_(2)明显高于研究组(P<0.05);两组患儿血清CD4+、CD8+、CD4+/CD8+较术毕即刻均明显改善,且对照组血清CD4+、CD4+/CD8+明显低于研究组,血清CD8+明显高于研究组(P<0.05)。术后2 h,两组患儿右心房的中性粒细胞计数较术毕即刻有所改善,且组间对比无统计学意义(P>0.05);两组患儿肺静脉的中性粒细胞计数较术毕即刻明显升高,而研究组低于对照组(P<0.05);两组患儿右心房及肺静脉的CD11b活性较术毕即刻明显升高,而研究组低于对照组(P<0.05)。随访期间,研究组患儿的并发症发生率(8.00%)明显低于对照组(24.00%)(P<0.05)。结论乌司他丁可有效减轻心脏术后患儿的炎症反应,具有良好的心肺功能保护作用,还可提高患儿的免疫功能,减少术后并发症的产生,临床应用价值较高。
Objective To analyze the effect of ulinastatin on inflammatory response,lung function protection and molecular biological mechanism in children after cardiac surgery.Methods A total of 100 children with congenital heart disease admitted to our hospital from January 2018 to July 2021 were selected as the research subjects.The children were divided into two groups by random number table method.The control group(n=50)received conventional treatment,and the study group(n=50)received ulinastatin treatment on the basis of the control group.The indexes of myocardial enzymes,inflammatory response,lung function,immune function indexes,neutrophil count and CD11b activity in the two groups were compared,and the incidence of complications in the two groups was recorded.Results At 2 h and 3 h after surgery,serum CK-MB and cTnI in both groups were significantly increased immediately after surgery,and those in control group were significantly higher than those in study group(P<0.05).The serum levels of IL-6 and TNF-αin two groups were significantly increased immediately after operation,and those in control group were significantly higher than those in study group(P<0.05).The PaO_(2)/FiO_(2)and P_((A-a))O_(2)in the two groups were significantly improved immediately after operation,and the PaO_(2)/FiO_(2)in the control group was significantly lower than that in the study group,while the P_((A-a))O_(2)was significantly higher than that in the study group(P<0.05).The serum CD4+,CD8+,CD4+/CD8+in the two groups were significantly improved immediately after operation,and the serum CD4+,CD4+/CD8+in the control group was significantly lower than that in the study group,and the serum CD8+was significantly higher than that in the study group(P<0.05).At 2 h after surgery,neutrophil count in right atrium of the two groups was improved immediately aftersurgery,and there was no statistical significance between two groups(P>0.05).The pulmonary vein neutrophil count of the two groups was significantly higher than that of the control group imme
作者
吴云斐
李寿林
WU Yunfei;LI Shoulin(Department of Pharmacy,Huaian Maternal and Child Health Hospital,Huaian 223002,Jiangsu,China)
出处
《中国分子心脏病学杂志》
CAS
2022年第4期4809-4814,共6页
Molecular Cardiology of China
基金
淮安市科技局科研立项(HAB201825)
江苏省卫健委高层次人才“六个一工程”拔尖人才科研项目(LGY2018044)。
关键词
乌司他丁
心脏病
炎症反应
肺功能
心肌酶
Ulinastatin
Heart disease
Inflammatory response
Lung function
Myocardial enzyme
