乌司他丁对体外循环时心肌组织黏附分子及P选择素表达的影响

The influence of ulinastatin on the expression of adhesive molecules of myocardial tissue

目的:观察乌司他丁对体外循环前后P-选择素及细胞间黏附分子-1mRNA的表达的影响。方法:40例行体外循环心内直视手术的先天性心脏病患儿,治疗组20例,预充液中加入乌司他丁1万IU/kg;对照组20例,应用常规预充液。于体外循环前后各取右心耳组织,采用RT-PCR方法检测心肌组织中P-选择素、ICAM-1 mRNA的表达水平。结果:两组P-选择素、ICAM-1mRNA表达量术后均较术前增高(P<0.01);术后对照组中其升高幅度明显高于治疗组(P<0.01)。结论:体外循环心肌组织黏附分子P-选择素及ICAM-1mRNA表达增加。乌司他丁可以通过抑制这些黏附分子的表达,从而减轻炎症反应。

Objective: To observe the influence of ulinastatin on the expression of P-selectin and ICAM-1 mRNA in myocardial tissue during cardiopulmonary bypass. Method: 40 patients with congenital heart disease undergoing CPB were selected and were divided into 2 groups randomly: study group(n=20,10000IU/kg ulinastatin was added into the prime fluid) and control group(n=20,routine prime fluid was used).Atrial biopsy specimens were collected before and after CPB.The expression of P-selectin and ICAM-1 mRNA in myocardial tissue was detected by PR-PCR technique.Results: The expression of P-selectin and ICAM-1 mRNA in myocardial tissue after CPB in both groups was increased and it was higher in control group than that in study group significantly(P<0.01).Conclusion: The expression of P-selectin and ICAM-1 mRNA is significantly increased after CPB and ulinastin can reduce the inflammatory response by inhibiting the mRNA expression of the adhesive molecules.