含氧血持续肺动脉灌注对体外循环后细胞因子水平的影响

Effect of Continuous Pulmonary Artery Perfusion with Oxygenated Blood on Cytokine Levels after Cardiopulmonary Bypass

目的探讨体外循环(cardiopulmonarybypass,CPB)期间含氧血持续肺动脉灌注对CPB术后细胞因子水平的影响。方法30例行二尖瓣置换术病人随机分成肺灌注组(15例)与对照组(15例)。肺灌注组病人CPB术中采用含氧血肺动脉持续灌注,对照组常规行二尖瓣置换术,未行肺动脉灌注。分别于术前、术后0h、6h抽取病人静脉血,采用双抗体夹心ABC-ELISA法测TNF-α、IL-8血浆浓度。结果同组术后较术前均明显升高(P<0.05);与对照组比较,肺灌注组术后0h、术后6hTNF-α与IL-8血浆浓度显著降低(P<0.05)。结论CPB心脏手术可引起术后细胞因子TNF-α、IL-8水平的升高,CPB术中含氧血持续肺动脉灌注可降低术后TNF-α、IL-8水平。

Objective To study the effect of continuous pulmonary artery perfusion with oxygenated blood on cytokine levels during cardiopulmonary bypass(CPB). Methods 30 cases undergoing mitral valve replacement were randomly divided into control group (n=15) and lung perfusion group (n=15). All cases underwent routine mitral valve replacement except the cases in the lung perfusion group were perfused with oxygenated blood continuously via pulmonary artery during CPB. The patients'plasma concentrations of TNF-α and IL-8 were measured before surgery, at 0 h, 6 h after surgery by means of ABC-ELISA. Results Significant increasing(P<0.05)of TNF-α and IL-8 levels were observed after surgery when compared with the same group at baseline(before surgery). Concentration of TNF-α and IL-8 at 0 h, 6 h post-operative in perfusion group were significantly reduced compared with control group (P<0.05). Conclusion CPB could induce the increasing of TNF-α and IL-8 levels after surgery. Continuous pulmonary artery perfusion with oxygenated blood during CPB demonstrate the effect of reducing in postoperative TNF-α and IL-8 levels.