去白细胞血预充对婴儿体外循环血浆TNF-α、IL-6、IL-8和NE的影响

The Impact of Leukocyte-removed Priming Fluid on Plasma Inflammatory Factors TNF-α,IL-6,IL-8,NE peri-cardiopulmonary Bypass in Infants

目的探讨去白细胞血预充对围体外循环(CPB)期婴儿血浆炎性因子TNF-α、IL-6、IL-8、NE的影响。方法60例<1岁的室间隔缺损患儿随机分成实验组和对照组,实验组用去白细胞血预充,对照组用常规库血预充。用ELISA法测定围体外循环期8个时点(CPB开始前、主动脉阻断10min、主动脉开放10min、CPB结束后2、6、12、24和48h)的血浆TNF-α、IL-6、IL-8、NE浓度。结果TNF-α、IL-6、IL-8、NE的浓度均在CPB开始后明显升高(P<0.01),CPB结束后2h达到高峰。实验组CPB后的TNF-α、IL-6、IL-8、NE浓度明显低于对照组(P<0.01或P<0.05)。结论去白细胞血预充可减少围体外循环期婴儿炎性因子TNF-α、IL-6、IL-8和NE的产生,减轻体外循环炎性反应。

Objective To investigate the impact of leukocyte - removed priming fluid on plasma inflammatory factors TNF - α,IL - 6,IL - 8, NE peri - CPB in infants. Methods Selected 60 infants , of less than 1 - year - old, with ventricular septal defect （VSD） were randomly assigned to the experimental group and the control group. The experimental group took blood leukocyte - removed priming fluid, and the control group took banked blood - derived priming fluid. The plasma TNF - α, IL - 6, IL - 8, NE concentrations were determinated by using ELISA at the corresponding period of cardiopulmonary bypass （ before CPB , aortic cross - clamping 10 min, aortic open 10 min , 2h,6h, 12h,24h and 48 h after the end of CPB ）. Results TNF - α, IL - 6, IL - 8, NE concentrations increased significantly after the start ofCPB （P〈0.01）, reaching a peak at 2h after the end ofCPB. TNF-α, IL-6, IL-8, NE concentrations of the experimental group after CPB were lower than those of the control group （ P 〈 0.01 ,P 〈 0.05 ）. Conclusion The plasma concentration of inflammatory factors TNF -α, IL -6, IL -8, NE can be decrease becaused of leukocyte -removed priming fluid peri -CPB in infants,leading to reduction of inflammedory response.