摘要
目的 观察阿拓莫兰对临床体外循环患儿中性粒细胞激活的干预作用。方法 随机抽取年龄 6～ 12岁先天性心脏病患儿 2 0例 ,单盲法配对分组为对照组 10例、干预组 10例 ,干预组体外循环预充液中加入阿拓莫兰 30mg/kg ,分别于术前 2 4h、体外循环开始 2 0min、复温前、体外循环结束前、术后 4h、术后 2 4h抽取静脉血 ,分离中性粒细胞 ,提取核蛋白 ,以电泳迁移率实验测定核转录因子κB活性变化 ;免疫组化检测细胞间粘附分子 (ICAM 1)的表达。结果 对照组体外循环开始 2 0min后 ,中性粒细胞核转录因子κB已被激活 ,在复温前达到峰值 ,术后 2 4h逐渐恢复至 (0 13± 0 0 4 ) (×10 6)术前水平 ;复温前ICAM 1开始表达增加 ,术后 4h达到峰值 ,术后 2 4h逐渐恢复至 (0 2 0± 0 0 9)(× 10 6)术前水平。干预组二者表达均下降 ,核转录因子κB活性于术后 4h下降为 0 12± 0 0 3(×10 6) ,ICAM 1于术后 4h下降为 2 5 2± 0 96 (× 10 6)与同时间点对照组 4 2 0± 0 82 (× 10 6)比较差异有显著意义 (P <0 0 5 )。结论 体外循环过程可激活中性粒细胞 ,中性粒细胞核转录因子κB活化 ,ICAM 1表达增强 ;阿拓莫兰可抑制中性粒细胞激活 ,减轻全身炎性反应。
Objective To study the intervention of redued glutathione for neutrophil activation in the process of extracorpereal circulation. Method 20 congenital heart disease children aged from 6 to 12 years were selected randomly,divided into control group and interventional group,patients of interventional group were added redued glutathione (30 mg/kg) in primiing fluid, then phlebotomized on the time of 24 hours before operation,20 minutes after CPB,rewarming,the end of CPB,4 hours after operation,24 hours after operation .After seperated neutrophil,we distilled nuclear protein and mensurated the activation of nuclear factor-κB by EMSA,assayed the expression of ICAM-1.by immunohistochemistry.Results Neutrophil nuclear factor-κB has been activated on the time of 20 minutes after CPB,arrives at the top on the time of rewarming,and resumes 24 hours after operation; ICAM-1 expresses on the time of rewarming,arrives at the top 4 hours after operation in control group.The data of interventional group is lower than the control group. Conclution Neutrophil nuclear factor-κB is activated and ICAM-1 is expressed in the process of extracorpereal circulation and play an important role in the inflammatary response happening in extracorpereal circulation,which could be relieved by redued glutathione.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2003年第16期1383-1386,共4页
National Medical Journal of China
