平衡超滤法中应用1,6-二磷酸果糖对炎症因子的影响

Effects of fructose 1,6 diphosphate and Balanced Ultrafiltration on the Release of Cytokines during Cardiopulmonary Bypass

目的:观察平衡超滤法及1,6-二磷酸果糖(FDP)对CPB中炎性介质的影响.方法;心瓣膜置换术36例随机分成对照组、平衡超滤(BUF)组及BUF+FDP组.在CPB开始、CPB30nim、CPB结束和术后2h抽血检测肿瘤坏死因子(TNF)、白细胞介素6(IL-6)和白细胞介素8(IL-8)的浓度.结果:对照组各类炎性介质的浓度随转流时间的延长不断上升(P＜0.01);BUF组各时点各炎症介质的浓度的增高有抑制作用,与对照组比较差异有统计学意义(P＜0.05～0.01);BUF+FDP组个时点炎性介质的浓度变化不明显,CPB结束、术后2h炎性介质的浓度与BUF组比较明显减少(P＜0.05～0.01).结论:平衡超滤法能降低CPB时体内炎性反应,在等量回输的林格氏液中加入FDP能进一步减少机体炎性反应.

Objective：To observe effects of fructose 1, 6 diphosphate （FDP） and balanced uhrafihration on the release of cytokines during cardiopulmonary bypass. Methods：Thirty -six patients undergoing heart valve replacement were involved, and they were divided into a control group, a balanced uhrafihration group （BUF） and a BUF ＋ FDP group randomly. Blood samples were drawn from the radial artery at the following time points： at the beginning of CPB, at the thirtith minute of CPB, at the end of CPB and at the second hour after CPB. The concentration of tumor necrosis factor （ TNF）, interleukin - 6 （ IL - 6）, interleukin -8 （IL -8） in plasma level were measured. Results：In the control group all kinds of cytokine increased obviously with the passage of CPB time（ P 〈 0. 001 ）. In the BUF group the increasing of the concentration of TNF, IL - 6, IL - 8 in plasma was inhibited. The concentration of cytokines in the BUF group was lower than that in the control group（ P 〈 O. 05 ）, In the BUF ＋ FDP group there was no difference of cytokine concentration among different time points. At the end of CPB and at the second hour after CPB, concentration of cytokines was further reduced compared with BUF group （P 〈 0. 05）. Conclusion：FDP and BUF can decrease the concentration of tumor necrosis factor （TNF）, interleukin -6 （IL- 6）, and interleukin -8 （IL -8） in plasma after CPB. It suggests that FDP and BUF may alleviate the systemic inflammation response after cardiopulmonary bypass.