PGE_1对成人心脏手术中心肌缺血再灌注损伤的保护作用

Effect of Prostaglandin E_1 on Myocardial Ischemia-reperfusion Injury in Adult Cardiac Surgery

目的:探讨成人心脏手术后白介素—6(IL—6)、白介素—8(IL—8)的变化及前列腺素E1(PGE1)对其的影响。方法:2002年1月～2002年12月,16例成人心脏手术中,男10例,女6例。随机分成两组,PGE1组8人和对照组8人,PGE1从手术开始应用到研究结束,剂量每分钟0.02～0.05μg/kg。分别在术前、体外循环(CPB)开始前、阻升主后60min、开升主后60min、开升主后120min、开升主后180min取颈静脉血,检测IL—6、IL—8的变化。结果:两组中IL—6、IL—8的水平在术前、CPB前、阻升主后60min三者之间无明显差异。但在开放循环后60min,120min,180min,IL—6、IL—8的水平明显高于术前(P<0.01)。然而接受PGE1组病人在开放循环后60min、120min、180min,IL—6、IL—8增高的程度明显低于对照组病人(P<0.01)。结论:IL—6和IL—8参与心肌缺血再灌注损伤。PGE1能减少IL—6和IL—8的产生,因此,PGE1对心肌缺血再灌注损伤具有保护作用,在临床上具有实际意义。

Objective: To determine the changes of interleukin-6(IL-6) and intereukin-8(IL-8) after adult cardiac surgery and the effect of prostaglandin E_1 (PGE_1) on IL-6 and IL-8. Methods:From January 2002 to December 2002,16 adults (10 males,6 females)undergoing cardiac operation were randomly divided in to two group:PGE_1 group (n=8) and control group (n=8).Patients in PGE_1 group received PGE_1 0.02 to 0.05 μg/kg -1 per min from the operation was performed until the study was over.Blood samples were obtained from the cervical vena.The levels of IL-6 and IL-8 were determined before operation and CPB,60 mins after aorta occlusion,60 mins and 120 mins after opening the aorta. Results:In both groups,there was no significant difference in IL-6 and IL-8 before operation and CPB and at 60 mins after aorta occlusion.IL-6 and IL-8 was increased significantly at 60,120,180 mins after opening the aorta,compared with that before operation (P<0. 01).The lelvels of IL-6 and IL-8 were significantly lower in PGEgroup than that in control group (P<0. 01). Conclusion:IL-6 and IL-8 involve in myocardial ischemia-reperfusion injury,PGE_1 is valuable in protecting myocardia from ischemia-reperfusion injury by reducing the IL-6 and IL-8.