摘要
目的 :探讨体外循环 (CPB)患者心肌炎症活性的改变。 方法 :随机选择 2 0例接受CPB手术的患者 ,于CPB前后及CPB期间获取心肌组织标本 ,以ELISA法测定核因子 κB(NF κB)的活性变化 ,同时测定围手术期血浆肿瘤坏死因子 α(TNF α)的浓度 ,记录主动脉阻断时间、转流时间及机械通气时间 ,分析心肌NF κB和血浆TNF α在围CPB期间的变化及其与影响因素和心功能之间的相关性。 结果 :①CPB前 17例患者心肌有NF κB核易位 ,其中 14例血浆TNF α浓度高于正常 ,CPB后 19例患者心肌NF κB活性较CPB前明显增加 ;②心肌NF κB活化程度与血浆TNF α浓度变化呈正相关 ;③心肌NF κB活化程度与临床结果及其他影响因素无明显相关性。 结论 :CPB前患者心肌即存在炎症活性 ,CPB后心肌NF κB活性增高 ,并可能是释放TNF
Objectives:To seek the changes of myocardial inflammatory activation in a cohort of patients undergoing cardiopulmonary bypass(CPB). Methods:Twenty patients undergoing CPB had plasma samples obtained for tumor necrosis factor α(TNF α) perioperatively. Myocardial tissue samples were obtained intraoperatively,both pre and post CPB. Myocardial nuclear factor kappaB(NF κB) nuclear translocation and plasma TNF α concentrations were analyzed by standard enzyme linked immunosorbent assay (ELISA). The durations of CPB, aortic crossclamping and the time to extubation were recorded. The changes of myocardial NF κB nuclear translocation and plasma TNF α concentrations were assessed by analysis of variance (ANOVA).The regression analysis was utilized to define the correlations among the optical densities of NF κB, concentrations of plasma TNF α,influencing factors and heart functions.Results:①Seventeen patients had NF κB nuclear translocation and plasma TNF α concentrations were elevated in fourteen of them before CPB, the activity of myocardial NF κB was significantly increased at the end of CPB in nineteen patients.②The correlation between the activity of NF κB and concentration of TNF α was significant.③The correlation among the activity of NF κB and clinical outcomes and other influencing factors were not significant. Conclusions:Myocardial inflammatory activation was present in the patients before CPB. The activity of myocardial NF κB was increased markedly and myocardium may be a source of TNF α induction in patients undergoing CPB.
出处
《医学研究生学报》
CAS
2003年第9期670-673,共4页
Journal of Medical Postgraduates
