摘要
目的:研究乌司他丁对体外循环肺损伤的保护作用并探讨其机制。方法:风湿性心脏病患者30例,随机分成2组,乌司他丁组(U组,n=15)给予乌司他丁2×104U/kg,于切皮后至CPB前缓慢静注半量,另半量加入预充液中随转机进入体内;对照组(C组,n=15)用等量生理盐水代替。术后2 h行支气管肺泡灌洗,分别测定支气管肺泡灌洗液(BALF)中中性粒细胞弹性蛋白酶(PMNE),肿瘤坏死因子-α(TNF-α)和丙二醛(MDA)含量以及术前、CPB后1,4 h肺氧合指数。结果:乌司他丁组BALF中PMNE,TNF-α和MDA含量较对照组明显降低(P<0.05),术后肺氧合指数较对照组显著降低(P<0.05),2组CPB后1,4 h肺氧合指数均较同组术前显著增高(P<0.05)。结论:乌司他丁可能通过抑制PMNE,减轻肺部炎症反应,清除氧自由基等,对体外循环所致肺损伤提供保护作用。
Objective To determine the protective effects and mechanism of ulinastatin on the lung injury during cardiopulmonary bypass （CPB）. Methods Thirty patients with rheumatic heart disease （RHD） were divided into 2 groups randomly. The ulinastatin group （Group U, n=15） received 1×10^4U/kg ulinastatin intravenously before the CPB and the same amount of ulinastatin was added into the primary solution. The control group （Group C ,n=15 ） received normal saline instead of ulinastatin. A brochioalveolar lavage was performed at 2 h after the cardiopulmonary bypass. Polymorphonuclear neutrophil elastase, tumor necrosis factor-α and MDA contents in the brochioalveolar lavage fluids were measured, and the lung oxygenate index was measured preoperatively and at 1 and 4 h after CPB termina- tion. Results Polymorphonuclear neutrophil elastase, tumor necrosis factor-α and MDA contents of Group U in the brochioalveolar lavage fulids were significantly lower than those of Group C （ P〈0.05 ） , and the lung oxygenate index of Group U at 1 and 4 h after CPB termination was also significantly lower than that of Group C. A significant increase of lung oxygenate index occurred in both groups at 1 and 4 h after CPB when compared with the same group at the baseline before CPB （ P〈0.05 ）. Conclusion Ulinastatin has the protective effects on the lung injury during CPB by decreasing polymorphonuclear neutrophil elastase, alleviating lung inflammatory reaction and reducing oxygen free radicals.
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2005年第6期670-672,共3页
Journal of Central South University ：Medical Science
关键词
肺损伤
乌司他丁
体外循环
中性粒细胞弹性蛋白酶
lung injury
ulinastatin
cardiopulmonary bypass
polymorphonuclear neutrophil elastase
