精氨酸对体外循环术后白细胞介素2变化的影响

Effects of Arginine on the Production of IL 2 in Patients of Cardiopulmonary Bypass

目的：探讨精氨酸增强体外循环术后细胞免疫功能是否系促进术后白细胞介素２的产生所致。方法：６０例体外循环手术病人分为两组，每组３０例。精氨酸组术前３天至术后７天每日静脉滴注精氨酸。于术前及术后１、３、５、７、１４天等时点抽外周血按Ｓｔａｎｄｌｅｒ法测定白细胞介素２水平。结果以均数±标准差表示，采用ｔ检验分析差异显著性。结果：对照组术后白细胞介素２水平明显下降，从术前７２．０±３．５（Ｕ／Ｌ，下同）降至术后第５天２９．１±５．２，第７天３５．８±３．９，约２周恢复正常。用药组下降幅度较小，术后第５天４６．７±４．２，第７天７０．１±４．４（组间差异Ｐ＜０．０５），约１周已接近术前水平。结论：精氨酸对体外循环术后白细胞免疫功能恢复具有明显的促进作用，增加术后白细胞介素２的产生可能是其重要机制。

Objective:To investigate whether the effects of arginine on cellular immunity is due to increased production of IL 2. Methods:Sixty patients of cardiopulmonary bypass were randomly divided into 2 groups (experimental group and control group,30 cases in each).Arginine hydrochloride was given at 0.2(child) 10 0(adult)g/kg·d by i.v.drip in the experimental group from the preoperative day 3th to the postoperative day 7th.The changes of IL 2 level in blood mononuclear cells were measured by Stadlers method on the preoperative day 1,postoperative day 1,3,5,7 and 14.All data presentated as ±s and Students t test was used in data analysis. Results:Arginine significantly increased the production of IL 2 on the postoperative day 5th (46.7±4.2 in experimental group vs.29.1±5.2 U/L in control group, p <0.05)and 7th (70.1±4.4 vs.35.8±3.9 U/L, p <0.05)in patients who underwent cardiopulmonary bypass. Conclusion:It is suggested that increased production of IL 2 may be the main mechanism by which arginine promotes the recovery of cellular immunity after cardiopulmonary bypass.