摘要
目的 观察心脏病患者体外循环前、后血中内毒素、可溶性细胞间粘附分子 1、肿瘤坏死因子 α及尿微量白蛋白的变化 ,探讨体外循环对血管内皮细胞损伤或激活及血管通透性的影响。方法 分别于诱导麻醉期间、转流 2 0分钟、转流结束、停机后 2小时、停机后 4小时、术后第 1天清晨取血及尿标本 ,用鲎试剂法测定血内毒素水平 ,酶联免疫吸附法测定可溶性细胞间粘附分子 1和放射免疫法测定肿瘤坏死因子 α及尿微量白蛋白的浓度。结果 转流开始后 ,各时相点的内毒素水平均高于转流前 (P <0 .0 5 ) ,体外循环结束后 2小时、体外循环结束后 4小时及术后第 1天清晨可溶性细胞间粘附分子 - 1和尿微量白蛋白浓度较体外循环前显著升高 (P <0 .0 5 ) ;而肿瘤坏死因子 α浓度只在体外循环结束及停机后 2小时显著高于体外循环前 (P <0 .0 5 )。结论 体外循环可诱导炎症反应致内皮细胞损伤或激活 ,并可致血管通透性增高。
Objective To observe the changes of endotoxin, soluble intercellular adhesion molecules 1(sICAM 1), tumor necrosis factor α(TNF α) and urinary micro albumin(U Mal) in children during cardiac operations in order to study the effects of cardio pulmonary bypass on the injury or activation of endothelial cell and vascular permeability.?Methods Twenty children undergwent cardiac operation with CPB were selected.?Plasma concentrations of endotoxin, sICAM 1, TNF α and U Mal were measured on induction of anesthesia(=baseline), bypass 20min, at the end of CPB, 2h after termination of CPB, 4h after of CPB and in the morning of first post operative day.?Results The concentrations of endotoxin, sICAM 1 and U Mal increased 2h after termination of CPB remained higher than those of the baseline, while the concentration of TNF α only increased at the end CPB and 2h after termination of CPB.?Conclusion CPB can induce activation damage of vascular endothelial cell,and increase vascular permeability.
出处
《创伤外科杂志》
2003年第1期49-51,共3页
Journal of Traumatic Surgery
