体外循环中S-100蛋白和神经元特异性烯醇化酶的变化及其与炎性细胞因子的关系

The changes of S-100 protein and neuronspeci fic enolase and its relationship with cytokin during cardiopulmonary bypass

目的 观察体外循环 (CPB)手术期间 S- 10 0蛋白和神经元特异性烯醇化酶 (NSE)的变化 ,探讨其与炎性细胞因子的关系。 方法 于 CPB前、复温即刻、主动脉开放和 CPB后 6、2 4小时采集 5 2例心脏病患者颈内静脉血 ,检测 S- 10 0蛋白和 NSE的浓度 ,并将其与炎性细胞因子白细胞介素 - 6 (IL- 6 )、白细胞介素 - 8(IL- 8)、肿瘤坏死因子 - α(TNF- α)和诱导型一氧化氮合成酶 (i NOS)的浓度变化进行相关性分析。 结果 CPB开始后即有 S- 10 0和 NSE升高 (P<0 .0 5 ) ,在术后 6小时达到高峰 (P<0 .0 5 ) ,术后 2 4小时均恢复至术前水平 (P>0 .0 5 ) ,二者变化趋势相同 ;S- 10 0蛋白和 NSE的变化与炎性细胞因子及 i NOS浓度的变化有明显的相关性。 结论 CPB期间可出现 S- 10 0和NSE的一过性升高 ,此与炎症反应中释放的炎性细胞因子及 i NOS的过度表达和产生有关 ,而患者多无明显的脑损害临床表现。

Objective To observe of changes serum 1evel of S- 10 0 protein and neuronspecific enolase(NSE) during cardiopulmonary bypass(CPB), an alyse the correlation between cytokines, tumor necrosis factor-alpha(TNF-α), interleukin-6(IL-6), interleuk in-8(IL-8), inducible nitric oxide synthase(iNOS) and S-100 or NSE respective ly. Methods Blood samples of fifty-two patients who underwe n t open heart surgery with CPB were collected from right internal jugular vein at p oints as pre-CPB, rewarming, aortic declamping, 6 hours and 24 hours after CPB. Cytokines, iNOS, S-100 and NSE were assayed accurately. In addition, its corre lation between them were also analysed. Results S-100 a nd NSE level raised in parallel after the initiation of CPB(P<0.05). High l evel of S-100 and NSE lasted until 6 hours after CPB(P<0.05), and decrease d to normal within 24 hours after CPB(P>05). There was a significant corr elation between the changes of cytokines, iNOS and S-100 or NSE re spectively. Conclusion There is a transient elevation of S-100 and NSE durin g CPB, which may eliminate within 24 hours after CPB. The increase of S-100 and NSE correlate significantly with the cytokines caused by CPB. The release of S-100 and NSE may be attributed to excessive expression and transcri ption of iNOS.