摘要
目的 本研究旨在观察心脏瓣膜置换术患者在体外循环 (CPB)各时段炎症因子和血流动力学的变化 ,并探讨肝素涂层膜肺对其的影响。方法 选择择期行双瓣置换术的患者 2 0例 ,随机分成两组 :A组为肝素化膜肺组 ,B组为对照组。全部患者分别在麻醉诱导前、主动脉阻断开放前、开放主动脉后 30min和术后 2h时取血测定细胞因子IL - 1β、IL - 6、IL - 8、TNF的浓度。并且分别在麻醉诱导前和术后 2h测定血流动力学指标。 结果 两组患者血液中的细胞因子 (IL - 1β、IL - 6、IL - 8、TNF)浓度 ,于CPB开始后即迅速上升。在CPB过程中IL - 1β、IL - 6、IL - 8和TNF的浓度均处于较高水平 ,且与麻醉诱导前相比部分有显著性差异 (p<0 .0 5 )。其中IL - 1β和IL - 6的浓度在术后 2h时仍有缓慢上升 ,IL - 8和TNF的浓度则在术后稍有下降。A组 (肝素化膜肺组 )和B组 (对照组 )相比较 ,细胞因子 (IL - 1β、IL - 6、IL - 8、TNF)浓度上升的程度均较小。开放 30min时IL - 1β和IL- 8的浓度在两组间有显著性差异 (p <0 .0 5 ) ,术后 2h时IL - 6的浓度在两组间的差异也有显著性 (p <0 .0 5 ) ,但TNF的浓度在两组间无显著性差异。结论 肝素化膜肺能改善CPB管路与血液的生物相容性 。
OBJECTIVE To evaluate the effect of heparin-coated membrane oxygenator on inflammatory response and alteration of hemodynamics during cardiopulmonary bypass(CPB).METHODS 20 patients were involved and divided into two groups: group A (heparin-coated membrane oxygenator), 10 patients; group B (non-heparin-coated membrane oxygenator), 10 patients. Blood samples were taken before operating, before aortic unclamping, 30 minutes after aortic unclamping and 2 hour after operation to measure the concentrations of Interleukin-1β(IL-1β), Interleukin-6(IL-6), Interleukin-8(IL-8) and Tumor Necorsis Factor(TNF).RESULTS All patients' concentrations of IL-1β, IL-6, IL-8 and TNF increased after beginning of CPB. And concentrations of IL-1β, IL-6, IL-8 and TNF during CPB were higher than those before operation(p<0.05). The concentrations of IL-8 and TNF decreased after operation. There were significant difference of IL-1βand IL-8 between the two groups at 30 minutes after aortic unclamping(p<0.05), and there were significant differences of IL-6 between the two groups 2 hours after operation(p<0.05). There were no significant differences of TNF between the two groups at any times points.CONCLUSIONS Heparin-coated membrane oxygenator is better than non-heparin-coated membrane oxygenator in repressing inflammatory response and biocompatibility.
出处
《中国体外循环杂志》
2003年第3期141-144,共4页
Chinese Journal of Extracorporeal Circulation
