氨茶碱在体外循环中对肺的保护作用

The protective effect of aminophylline on lung during cardi opulmonary bypass

目的 探讨氨茶碱对体外循环 (CPB)所致肺损伤的保护作用。 方法 选择心瓣膜置换术患者 2 0例 ,采用随机化分组表分为氨茶碱组和对照组 ,每组 10例。氨茶碱组于麻醉诱导后缓慢 (5分钟 )静脉注射氨茶碱 (5 mg/kg) ,其后按 0 .5 mg/ kg·h经微量泵持续静脉注射 ;对照组用等容量平衡盐溶液静脉注射。两组均于 CPB前、CPB结束后 1、8和 2 4小时测定肿瘤坏死因子 -α(TNF-α)、白细胞介素 - 8(IL - 8)、白细胞介素 - 10 (IL - 10 )的血浆水平 ,同时测量两组患者围术期血流动力学、呼吸指数 (RI)、右心房血 /左心房血中性粒细胞比值和血浆丙二醛 (MDA)含量等。结果 CPB结束后 1小时和 8小时 ,对照组 RI较 CPB前和氨茶碱组明显增高 (P<0 .0 5 ) ,氨茶碱明显抑制了中性粒细胞在肺内的聚集 ,抑制 TNF- α和 IL- 8的释放 ,减少 MDA产生 ,促进 IL- 10的产生。 结论 氨茶碱能够减轻炎性反应和

Objective To investigate the protective effect of amino phylline on lung injury induced by cardiopulmonary bypass (CPB). Method s Twenty patients who underwent cardiac valve replacement were randomly divided into two groups (each group 10 cases). Aminophylline group: aminophylli ne (5mg/kg) was injected slowly via vein after anesthesia and maintained with 0. 5mg / kg·h dose until the end of CPB. Control group: aminophylline was replaced by Ringer's lactated solution. Before CPB and 1,8,24h after CPB, blood tumor ne cr osis factor-alpha(TNF-α),interleukin-8(IL-8) and interleukin-10(IL-10)sam ples were determined. Hemodynamics, respiratory index (RI), neutrophil cell ratio of right atrium blood to left atrium blood, and plasma malondiadehyde (MDA) were d etermined perioperatively. Results RI at 1h and 8h after CP B in control group was higher than the baseline value and that in the aminophylline group (P<0.05) . Compared with control group, aminophylline can significantly restrain neutroph il cell accumulation in the lung, reduce releasing of TNF-α, IL-8 and MDA, in crease releasing of IL-10. Conclusion Aminophylline has anti -inflammatory effect and protective effect on lung injury induced by CPB.