乌司他丁对体外循环心脏病人血浆TNF-a,IL-6和IL-8的影响

Influence of ulinastatin of the release of concentration of TNF-a,IL-6 and IL-8 levels in plasma after cardiopulmonary bypass

摘要:

目的通过观察体外循环(CPB)中预充乌司他丁对CPB心脏病血浆TNF-a,IL-6和IL-8的影响.方法选择40例主动脉阻断时间在30 min以上的心脏直视手术患者,随机分为实验组20例对照组20例.实验组在常规CPB预充液中加入乌司他丁1.5万U/kg,对照组用生理盐水.分别在手术开始前,CPB结束后即刻,CPB结束后3,6及24 h抽取桡动脉血,采用ELISA法测定血浆肿瘤坏死因子、白介素-6(IL-6)、白介素-8(IL-8)的浓度.结果实验组患者TNF-a,IL-6和IL-8以CPB结束后即刻0,3和6 h血浆浓度明显低于对照组(P＜0.01),IL-6和IL-8在CPB结束后24h也低于对照组(P＜0.05).结论乌司他丁可明显减少CPB术后TNF-a,IL-6和IL-8的释放,可减轻CPB术后全身炎症反应.

Abstract:

Objective: Investigate whether Ulinastalin can reduce the systemic inflammatory response which induced by cardiopulmonary bypass. Methods: forty patients scheduled for cardiac surgery under 20 min following CPB were randomly divided into two groups. in treated group (n=20); ulinastalin was added into the prine before CPB. but in control group (n=20); saline was added. Blood samples were drawn from the vadial artery at the following time points: before CPB; at the end of CPB; three hours after CPB. six hours after CPB; twenty-four hours after CPB. the concentration of tumor necrosis factor-a (TNF-a). interleukin-6 (IL-6) and interleukin-8 (IL-8) in plasma level were measured. Results: TNF-a, IL-6 and IL-8 in the treated groups were lower than those in the control group at the end of CPB, 3 hours after CPB and 6 hours after CPB(P<0.01). IL-6 and IL-8 in the treated group were lower than the control group at 24 hours after CPB (P<0.05). Conclusion: Ulinastalin can release the concentration of TNF-a, IL-6 and IL-8 in plasma after CPB and may alleviate the systemic inflammatory response after cardiopulmonary bypass.