小儿体外循环术中抑肽酶促进内源性白细胞介素-10释放的研究

Aprotinin enhancing release of endogenous interleukin-10 during extracorporeal circulation in children

目的 探讨小儿体外循环 (ECC)术中抑肽酶促进内源性IL 10释放的作用及量效关系。方法 按入选标准筛选病例并随机分成 6组 :对照组 (A1 组 ,n =15 ) ,小剂量抑肽酶组 (B1 组 ,n =15 ) ,大剂量抑肽酶组 (C1 组 ,n =15 ) ,激素组 (A2 组 ,n =2 0 ) ,激素 +小剂量抑肽酶组 (B2 组 ,n =2 0 ) ,激素 +大剂量抑肽酶组 (C2 组 ,n =2 0 )。用酶联免疫吸附试验法测定各患儿在术前 ,ECC 30min ,ECC结束后 2h ,2 4h ,7d5个时间点血清IL 10的浓度。结果 各组ECC 30min ,ECC结束后 2h血清IL 10浓度与术前相比显著增高 (P <0 0 1) ;且B1 、C1 组与A1 组相比 ,B2 、C2 组与A2 组相比及C1 组与B1 组比较 ,C2 组与B2 组比较 ,IL 10水平增高更为明显 ,各组间差异有显著性 (P <0 0 1) ;A1 、B1 组术后住院日明显延长 (P<0 0 5 )。结论 抑肽酶能促进内源性IL 10的释放 。

Objective To explore Aprotinin enhancing release of endogenous interleukin-10(IL-10),and dose-effective relation during extracorporeal circulation(ECC)in children.Methods Patients were selected according to standards,and randomly divided into six groups:control group(group A 1,n=15),low-dose aprotinin group(group B 1,n=15),high-dose aprotinin group(group C 1,n=15),and dexamethasone group(group A 2,n=20),dexamethasone + small-dose aprotinin group(group B 2,n=20),dexamethasone+full-dose aprotinin group(group C 2,n=20).Serum level of IL-10 was measured by enzyme-linked immunosorbent assay technique before operation,30 minutes after ECC,and at 2 hours,24 hours,7 days after the end of ECC.Results A significant increase(P<0.01)of IL-10 concentration occurred in all groups at 30 minutes after ECC,and at 2 hours after the end of ECC.Moreover,when group B 1 and group C 1 compared with A 1,group B 2 and group C 2 compared with A 2,and group C 1 compared with B 1,group C 2 compared with B 2,there were statistical significances in the increase of IL-10(P<0.01).The hospital stay of group A 1 and group B 1 prolonged markedly(P<0.05).Conclusion Aprotinin can enhance the release of endogenous IL-10,and the effect of Aprotinin has positive correlation with dosage.