盐酸戊乙奎醚对体外循环肺损伤的临床观察

The protection effect of penehyclidine hydrochloride on cardiopulmonary bypass induced lung injury

目的探讨盐酸戊乙奎醚（PH）对体外循环肺损伤的保护作用。方法选取24例体外循环下心脏手术患者，随机分成两组，每组12例：盐酸戊乙奎醚组（P组），在麻醉开始前和体外循环开始前经静脉给盐酸戊乙奎醚各一次，剂量均为0．02mg／kg；常规对照组（C组）在相应给药时间予等体积生理盐水静脉注射。在围术期不同时间点检测肺动态顺应性和氧合指数，评估肺功能的变化；同时检测血肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）。结果两组患者术后肺顺应性及氧合指数均较术前低（P〈0．05）；P组术中和术后多个时间点的肺顺应性及氧合指数明显高于对照组（P〈0．05）。所有患者血TNF—α、IL-6、IL-8均较术前明显升高（P〈0．05），但P组明显低于对照组（P〈0．05）。结论盐酸戊乙奎醚对体外循环肺损伤有一定的保护作用。

Objective To study the protection effect of penehyclidine hydrochloride on cardiopulmonary bypass induced lung injury. Methods Twenty - four patients suffered congenital heart disease and prepared to receive operation with cardiopulmonary bypass were divided randomly into two groups as： penehyclidine hydrochloride group （group P） and control group （group C）, 12 patients in each group. The patients in group P received intravenous penehyclidine hydrochloride 0. 02 mg/kg at the beginning of induction of anesthesia and the beginning of cardiopulmonary bypass, and the patients in group C received equal volume saline respectively. At different point of per/operative period, dynamic compliance of lung and oxygenation index were detected to evaluate the change of pulmonary function, and the blood TNF - α, IL -6, IL -8 levels were detected. Results Dynamic compliance of lung and oxygenation index decreased after cardiopulmonary bypass in both two groups （ P 〈0. 05 ）. In the group P, Dynamic compli- ance of lung and oxygenation index were significantly higher than that in the control group after cardiopulmonary bypass （ P 〈 0. 05 ）. The levels of blood TNF - α, IL - 6, IL - 8 increased after eardiopulmonary bypass in both two groups （ P 〈 0.05 ）. The levels of blood TNF - α, IL - 6, IL - 8 in group P were higher than that in the control group respectively （ P 〈 0. 05 ）. Conclusions Penehyclidine hydrochloride showed protection effect of cardiopulmonary bypass induced lung injury in this study.