乌司他汀对心肺复苏术后肿瘤坏死因子及白细胞介素-6变化影响的研究

Influence of ulinastain on tumor necrosis factor and interleukin-6 in patients after cardiopulmonary resuscitation

目的观察心肺复苏术(CPR)后全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)的发生,探讨乌司他汀对炎症介质的干预作用。方法将2005年12月至2007年8月中南大学湘雅医院急诊科救治的CPR后存活>72h的32例患者,随机分为乌司他汀治疗组(n=15)和对照组(n=17),以10名体检健康者为正常组(n=10),治疗组和对照组于心脏搏动恢复72h后抽取外周血,比较3组肿瘤坏死因子-α(tumor necrosisfactor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6),同时对患者进行SIRS的评估。结果CPR后两组患者外周血TNF-α、IL-6均高于正常组(P<0.01)。治疗组患者TNF-α、IL-6明显低于对照组(P<0.01)。治疗组患者SIRS的发生率明显低于对照组(20.0%对64.7%)。结论乌司他汀能够有效地抑制CPR后机体炎症反应,可能对患者重要脏器功能起到保护作用。

Objective To investigate the incidence of systemic inflammatory response syndrome（SIRS） after cardiopulmonary resuscitation（CPR） and to observe the effect of ulinastain in inhibition of inflammatory mediator. Methods Thirty- two patients surviving more than 72 hours after CPR were divided into ulinastain group and control group randomly. Activity of TNF-α and IL-6 of these patients was detected. In the meantime,all patients were evaluated by SIRS diagnosis and all data were compared between two groups, Results Activities of TNF-α and IL-6 in patients after CPR were significantly higher than that of normal people（ P 〈 0. 01 ）. Activities of TNF-α and IL-6 in ulinastain group were significantly lower than those of control group（ P 〈0. 01 ）. The incidence rate of SIRS in ulinastain group was only 20. 0% and that in ulinastain group was 64.7%. Conclusion Ulinastain plays a role in inhibition of inflammatory mediators and can protect the main organ function of the patients.