摘要
目的探讨前列腺素E1脂肪乳剂(L ipo-PGE1)在体外循环(CPB)中对心肌缺血-再灌注损伤(M IR I)的保护作用。方法选取我院明确诊断的心脏瓣膜病、先天性心脏病房间隔缺损(A SD)、室间隔缺损(V SD)患者32例,随机分成两组,每组16例。L ipo-PGE1组:CPB开始前持续静脉泵滴入L ipo-PGE1(剂量2ng/kg.m in)至升主动脉开放后2h;对照组:滴入等容量的生理盐水。两组患者均分别于CPB开始前,升主动脉开放后1、2、6和24h等时点抽取动脉血,测心肌肌钙蛋白I(cT n I)、肌酸激酶同工酶M B(CK-M B)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和可溶性细胞间黏附分子-1(sICAM-1)的表达值。结果CPB前两组患者的cT n I,CK-M B,IL-6,TNFα-和sICAM-1指标比较差异无统计学意义(P>0.05),升主动脉开放后1、2、6和24h均较CPB前明显升高(P<0.01),但L ipo-PGE1组较对照组低(P<0.05)。结论CPB前至升主动脉开放后2h持续静脉泵滴入L ipo-PGE1(剂量2ng/kg.m in),能有效地抑制IL-6,TNFα-的释放,减弱sICAM-1表达,减轻炎症反应和对心肌细胞的损伤,对CPB术中M IR I具有保护作用。
Objective To investigate the protective effects of liposome prostaglandin E1（Lipo-PGE1） on myocardial ischemia-reperfusion injury （MIRI） during cardiopulmonary bypass （CPB）. Methods Thirty-two patients with clearly diagnosed heart valve disease and congenital heart disease such as atria septal defect （ASD） and ventricular septal defect （VSD） were selected in our hospital. The patients were randomly divided into two groups （16 patients in each group）, Lipo-PGE1 group： Lipo-PGE1（2ng/kg·min） was continuously pumped before starting of CPB until 2 h after ascending aortic off-clamping; control group： using the same volume of normal saline, arterial blood samples were taken before CPB, at 1, 2, 6 and 24 h after the ascending aortic off-clamping. The value of cardiac troponin I （cTnI）, creatine kinase MBmass （CK-MB）, interleukin-6 （IL-6）, tumour necrosis factor-α （TNF-α）, intercellular adhesion molecule-l（sICAM-1） were measured. Results cTnI, CK-MB, IL-6, TNF-α and sICAM-1 showed no significant difference in the two groups before CPB （P〉0. 05）. At 1,2, 6 and 24h after ascending aortic off-clamping, those values rose significantly than before CPB（P〈0. 01）, but Lipo-PGE1 group＇s values were lower than those in the control group （P〈0. 05）. Conclusions Lipo-PGE1 （2ng/kg·min） continuously pumped from before CPB to 2h after ascending aortic off-clamping can inhibit effectively the production of IL-6, TNF-α, and reduce the expression of sICAM-1, attenuate the process of inflammation, lighten the injuries of myocardial cells, and effectively protect the MIRI during CPB open heart surgeries.
出处
《中国胸心血管外科临床杂志》
CAS
2006年第4期238-241,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
体外循环
缺血-再灌注损伤
前列腺素E1
脂肪乳剂
Cardiopulmonary bypass
Ischemia-reperfusion injury
Prostaglandin El, liposome diluent
