摘要
目的探讨白细胞滤除对犬体外循环(CPB)诱发全身炎性反应的影响。方法蒙古犬 12只,体重25～30kg,随机分为2组(n=6)：对照组(C 组)和白细胞滤除组(LD 组),C 组不使用白细胞滤器,LD 组将滤器安装于 CPB 的静脉回流端,在 CPB 2min 时打开滤器5min。分别于 CPB 前即刻 (T_0)、阻断升主动脉后即刻(T_1)、阻断升主动脉30min(T_2)、开放升主动脉后5min(T_3)、停 CPB 即刻 (T_4)、停 CPB 2h(T_5)自股静脉抽血,测定白细胞计数和血浆 L-选择素、白细胞介素(IL)-6、IL-8、髓过氧化物酶(MPO)水平。于过滤后30、60、90min 时测定滤器内 IL-6、IL-8浓度,并在过滤后90min 时取滤膜行病理学检查。结果 LD 组 T_1时白细胞计数低于 C 组；两组 CPB 期间血浆 L-选择素、IL-6、IL-8浓度均高于 T_0,T_5时 LD 组血浆 L-广选择素、IL-6、IL-8、MPO 水平均低于 C 组。过滤后60、90min 时滤器中 IL-6、IL-8浓度高过滤后30min；滤器内白细胞滤膜全层布满白细胞,入血面白细胞多于出血面。结论白细胞滤除能抑制犬 CPB 所引起的全身炎性反应。
Objective To assess the effect of leukocyte filtration on systemic inflammatory response to cardiopulmonary bypass. Methods Twelve mongrel dogs weighing 25-30 kg were randomly divided into 2 groups （n = 6 each）： control group （C） and leukocyte depletion group （LD） . The dogs were anesthetized with intraperitoneal pentobarbital 25 mg· kg^-1. The trachea was intubated. The arterial line of CPB was connected with aortic cannula and the venous line with a cannula inserted into right atrium. The leukocyte-depletion filter LD-1 was positioned in the venous line of CPB circuit. Aorta was clamped at 10 min of CPB and St. Thomas cardioplegic solution 20 ml· kg^- 1 was injected into the root of aorta. The filter was used for 5 min starting from 2 min of CPB. Aorta was clamped for 60 min. Blood samples were taken from femoral vein before CPB （TO, baseline ）, immediately after aortic clamping （ T1 ） at 30 min of aortic clamping （ T2 ） 5 min after aortic unclamping （T3） at the termination of CPB （T4） and 2 h after termination of CPB （T5） for leukocyte count and determination of plasma L-selectin, IL-6 and IL-8 concentrations and MPO activity. The IL-6 and IL-8 concentrations in the filter LD-1 were measured at 30, 60 and 90 min after leukocyte filtration. The membrane of filter LD-1 was taken at 90 min after filtration for microscopic examination. Results The leukocyte count was significantly lower at T1 in LD group than in C group. The plasma L-selectin, IL-6, IL-8 concentrations and MPO activity were significantly increased during CPB as compared to the baseline at TO in both groups but were lower at T5 in LD group than in C group. The IL-6 and IL-8 concentrations in LD-1 filter were increased at 60 and 90 min after filtration as compared to those at 30 min. The filter membrane was covered with enormous number of leukocytes. Conclusion Leukocyte filtratinn can decrease systemic inflammatory response to CPB in dogs.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2006年第1期19-21,共3页
Chinese Journal of Anesthesiology
基金
国家自然科学基金青年基金(30400439)
