七氟醚对心脏瓣膜置换术患者NF-κB和TNF-α表达的影响

The effects of sevoflurane on expressions of NF-κB,TNF-α in patients undergoing cardiac valve replacement

目的观察七氟醚对心脏瓣膜置换术患者核因子-κB(NF-κB)和肿瘤坏死因子α(TNF-α)的影响,探讨其心脏保护作用的可能机制。方法30例拟行心脏瓣膜置换术患者,随机均分为七氟醚组(S组)和对照组(C组)。用流式细胞仪检测围术期血NF-κB活性,用酶联免疫法(ELISA)检测围术期血浆TNF-α浓度。结果心肺转流(CPB)后两组NF-κB活性和TNF-α水平均较CPB前显著增加(P<0.05)。CPB后各时点NF-κB和TNF-α水平,C组显著高于S组(P<0.05)。结论七氟醚可能通过抑制NF-κB的表达与活性,进而降低TNF-α浓度,减轻了CPB时的全身炎症反应而发挥心脏保护作用。

Objective To study the effects of sevoflurane on expressions of NF-κB and TNF-α in patients undergoing valve replacement and the mechanism of sevoflurane protecting heart. Methods Thirty patients undergoing cardiac valve replacement were randomly divided into control group（group C）and sevoflurane group（group S）. Blood samples were obtained for detecting NF-κB and TNF-α. The expression of NF-κB was analyzed by flow cytometer, plasma TNF-α concentration was analyzed by enzyme linked immunsorbent assay（ELISA）. Results （1）The expressions of NF-κB and TNF-a were significantly increased after CPB than those before CPB in two groups（P〈0.05）. （2）The expressions of NF-κB and TNF-α were significantly increased in group C than those in group S after CPB （P〈0.05）. Conclusion Sevoflurane likely inhibits the expression of NF-κB and TNF-α, resulting in alleviation of SIRS and protection of the heart.