腺苷对体外循环下心脏手术患者血浆细胞因子的影响

Effect of cAMP on Serum Cytokin in Patients with Cardio-operation by CPB

【目的】探讨腺苷对体外循环心脏手术患者围术期血浆细胞因子的影响。【方法】回顾性分析60例体外循环心脏手术患者的临床资料:A组(33例)为腺苷(cAMP处理组,B组(27例)为等量生理盐水处理组;分别于术前(T0)、主动脉开放10 min(T1)、12 h(T2)、24 h(T3)采集患者动脉血标本,用ELISA法检测围术期血浆TNF-αI、L-8I、L-10、cTnT水平;用自动生化仪测量围术期血浆CK-MB水平。术毕采集右房组织标本,镜下观察肺组织炎症反应。【结果】两组患者术中、后各时点TNF-αI、L-8I、L-10水平均较术前升高(P<0.05),在T0、T1两组间无明显差异(P>0.05);在T3、T4两各时点TNF-αI、L-8水平A组较B组明显降低(P<0.05),而IL-10水平A组较B组明显升高(P<0.05);术后T2、T3两个时点CK-MB、cTnT水平较术前(T0)明显升高(P<0.05),但A组较B组明显降低(P<0.05)。镜下观察两组病人均有部分心肌结构破坏,炎症反应,但A组病人较B组轻。【结论】腺苷对缺血再灌注的心肌组织具有一定的保护作用。

[Objective]To study the effect of cAMP on serum cytokin in patients with cardiooperation by CPB. [Methods]The clinical data of 60 patients were analyzed retrospectively： the patients in group A（ n = 33）were treated with cAMP, and group B（ n = 27） with normal saline. The blood samples were collected in preoperation（T0 ）, the time of open aorta （T1）,end of operation（T2 ）, 12h（T3 ） and 24h（T4 ） after operation. The serum concentration of TNF-α, IL-8, IL-10, cTnT were tested by ELISA, and CK-MB was tested by biochemical instrument. The inflammato- ry changes of cardiac muscle were observed by optical microscope. [Results]The postoperation serum concentrations of TNF-α, IL-8 of patients in group B were higher than in group A, and the serum concentration of IL-10 was reverse（ P 〈0.05）. The serum concentrations of cTnT and CK-MB in T2 and T3 were higher than in To ,and there was obvious difference between two groups（ P 〈0. 05）. [Conclusion]The cAMP has certain degree of protective effect on ischemia- reperfusion injury of cardiac muscle.