摘要
目的探讨乌司他丁对体外循环二尖瓣置换术患者血浆促炎性细胞因子的影响。方法选择16例拟在体外循环(CPB)下行二尖瓣置换术的患者,随机分为两组,每组8例。乌司他丁组(U组)患者接受乌司他丁12000IU/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)用等量复方氯化钠代替。分别于诱导后切皮前(T1)、转流30minT2)、停CPB1(T3)、4(T4)、24(T5)测定血浆肿瘤坏死因子(hhh(TNF-α)、白介素-(6IL-6)浓度。结果两组T2、T3、T4、T5各时间点TNF-α、IL-6浓度明显高于(1P<0.01或P<T0.05)。两组TNF-α浓度在T2时间点开始升高(P<0.01),至T3时间点达到峰值(P<0.01),在T4时间点开始下降并持续至T5,但T4、T5均高于基础值(1P<0.01)。两组IL-6浓度在T2时间点开始持续升高(P<0.01),T4时间点达到T峰值(P<0.01),在T5时间点开始下降,但仍高于基础值T(P<0.05)。U组T2、T3、T4、T5各时点TNF-α、IL-6浓度明1显低于C组(P<0.01或P<0.05)。结论乌司他丁能明显抑制二尖瓣置换术患者促炎性细胞因子TNF-α、IL-6的释放,可抑制CPB心脏手术导致的全身性炎性反应,从而减轻缺血再灌注损伤。
Objective To investigate the effects of ulinastatin on proinflammatory eytokines during mitral valve replacement under hypothermic cardiopulmonary bypass. Methods Sixteen patients for mitral valve replacement surgery were randomly divided into two groups： the ulinastatin group （group U,n=8） received 6000 IU/kg ulinastafin intravenously before CPB and same dose of ulinastatin added into the primary solution. The control group（group C, n=8）reeeived normal saline instead of ulinastatin. Blood samples were taken before skin ineision（T1）,30 min after start of CPB （T2） and 1 h （T3）,4 h （T4）and 24 h （T5） after termination of CPB for determination of plasma TNF-α and IL-6. Results The plasma level of TNF-α and IL-6 increased after CPB in both groups,TNF-α and IL-6 level at T2,T3,T4 and T5 in group U were lower than that in group C （P〈0.01 or P〈0.05）. Conclusion Ulinastatin is effective in reducing CPB-indueed inflammatory response in the patients undergoing mitral valve replacement.
出处
《中国心血管病研究》
CAS
2006年第2期120-122,共3页
Chinese Journal of Cardiovascular Research
基金
清远市科技计划项目[清科字(2005)28号-1]
关键词
乌司他丁
细胞因子类
二尖瓣
心肺转流术
再灌注损伤
心脏外科手术
Ulinastatin
Cytokines
Mitral valve
Cardiopulmonary bypass
Reperfusion injury
Cardiac surgical procedures
