心脏瓣膜置换术患者围术期细胞因子浓度变化以及脑苷肌肽的影响

The Effects of Cattle Encephalon Glycoside and lgnotin injection on Serum Level of cytokine in Patients undergoing Cardiac Valve Replacement

目的探讨体外循环(CPB)下心脏瓣膜置换术患者围术期血清细胞因子浓度的变化以及脑苷肌肽对其影响。方法40例CPB下心脏瓣膜置换术患者,随机分为脑苷肌肽组(A组)和对照组(B组),每组20例。A组于麻醉诱导后静脉注射脑苷肌肽20 ml(每毫升含神经节苷脂50μg、多肽3.2 mg),B组给等容积生理盐水。分别于给药前(T1)、CPB结束(T2)及结束后2h(T3)、6h (T4)、24h(T5)各时间点采集颈内静脉球部血,测定细胞因子白介素-6(IL-6)、白介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)浓度。结果两组IL-6、IL-8和TNF-α浓度在CPB后均显著升高,组间比较显示B组IL-6和IL-8浓度在T3、T4和T5时间点均显著高于A组(P<0.05),B组TNF-α浓度在T2、T3、T4和T5时间点均显著高于A组(P<0.05)。结论脑苷肌肽可以减少体外循环心脏瓣膜置换手术中炎性细胞因子IL-6、IL-8和TNF-α的释放。

Objective To investigate the effects of cattle encephalon glycoside and ignotin injection on serum level of IL-6, IL-8 and TNF-α during cardiac valve replacement with cardiopulmonary bypass （CPB）. Methods forty patients undergoing cardiac valve replacement with CPB were randomly divided into two groups： cattle encephalon glycoside and ignotin injection group （group A, n = 20） and control group （group B, n = 20） . In group A cattle encephalon glycoside and ignotin injection 20ml was given i. v. after induction of anesthesia. In group B normal saline was given instead of cattle encephalon glycoside and ignotin injection. Blood samples were taken from jugular bulb after induction of anesthesia （T1） , discontinuation of CPB （T2）, 2h, 6h and 24 h （T3, T4 and T5） after discontinuation of CPB for determination of serum levels of IL-6, IL-8 and TNF-α. Results Serum levels of IL-6, IL-8 and TNF-αwere significantly increased after CPB. At time of T3, T4 and T5, serum levels of IL-6 and IL-8 were significantly higher in group B than in group A （P 〈 0. 05 ）. At time of T2,33, T4 and T5, serum levels of TNF-αwere significantly higher in group B than in group A. Conclusion cattle encephalon glycoside and ignotin injection could decrease the release of IL-6, IL-8 and TNF-αduring cardiac valve replacement with CPB.