乌司他丁对体外循环下双瓣膜置换患者炎症反应的影响

Effect of ulinastatin on plasma tumor necrosis factor-alpha and A-aDO_2 in patients undergoing mitral valve and aortic valve replacement under cardiopulmonary bypass

目的:探讨乌司他丁对于体外循环(CPB)下双瓣膜置换患者肿瘤坏死因子(TNF-α)与肺泡-动脉血氧分压差(A-aDO2)的影响。方法:40例行CPB下双瓣膜置换患者,其中20例使用乌司他丁,检测TNF-α与A-aDO2。结果:两组CPB开始后2h和24h TNF-α均有明显升高,非乌司他丁组较乌司他丁组为高,差异有显著性。两组CPB开始后2h和24h A-aDO2均有明显升高,非乌司他丁组较乌司他丁组为高,差异有显著性。结论:乌司他丁能够减少CPB下双瓣膜置换患者TNF-α的产生,降低患者的A-aDO2,从而减轻患者的炎症反应损伤。

Objective To evaluate the effect of ulinastatin on plasma tumor necrosis factor-alpha （TNF-α） and AaDO2 in patients undergoing mitral valve and aortic valve replacement under cardiopulmonary bypass （CPB）. Methods 40 patients undergone mitral valve and aortic valve replacement under CPB were assigned to uhnastatin group （received ulinastatin） or control group. Blood samples were collected for determination of plasma TNF-α and A-aDO2. Results TNF-α and A-aDO2 were increased at 2 h and 24 h after CPB in both groups, and were significantly higher in control group than in ulinastatin group （P 〈 0.05）. Conclusion Ulinastatin may reduce the release of TNF-α and decrease the value of AaDO2, and then decrease the harm of systemic inflammatory reaction syndrome.