肺动脉灌注肺保护液对体外循环相关性炎症反应影响的实验研究

The effect of pulmonary artery perfusion with hypothermic lung-protective solution on cardio-pulmonary bypass relative inflammatory response

目的探讨肺动脉灌注低温肺保护液对体外循环相关性炎症反应的影响。方法将20只杂种犬随机分为对照组和实验组。实验组在阻断升主动脉后经肺动脉灌注低温肺保护液,对照组则行常规体外循环、不灌注肺保护液,分别于诱导前(T1),转流1h(T2),停机1h(T3),停机2h(T4)抽取动脉血,测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-10(IL-10)浓度。结果两组实验犬血浆TNF-α、IL-6和IL-10的浓度,在T2-T4各时点与体外循环前比较均明显增加(P<0.05);T2-T4时点实验组血浆TNF-α和IL-6浓度明显低于对照组(P<0.01),IL-10浓度明显高于对照组(P<0.05)。结论体外循环期间经肺动脉灌注低温肺保护液可抑制体外循环过程中促炎细胞因子TNF-α和IL-6的释放,促进抗炎细胞因子IL-10的释放,从而减轻体外循环引起的全身炎症反应。

Objective To determine the effect of pulmonary perfusion with hypothennie protective solution on inflammatory response during cardiopulmonary bypass （CPB） .Methods Twenty adult mongrel dogs were randomly divided into two groups. During CPB, the study group were perfused with 4℃ protective solution, control group were not. The blood samples were collected at the same time point of preoperation（ T1 ）, 60 rain of cardiopulmonary bypass（ T2 ）, and 1 hour（ T3 ）, 2 hour （T4） after cardiopulmonary bypass. Plasma concentration of IL-6, IL-10, TNF-α were detected with ELISA. Results The plasma levels of IL-6, IL-10, TNF-αin each group were significantly increased at T2, T3, T4. The plasma levels of IL-6 and TNF-αin study group were significantly lower than control group at T2, T3, T4. The plasma levels of IL- 10 were significantly higher than control group at T2, T3, T4. Conclusion This study demonstrated that pulmonary artery perfusion with the hypothermic protective solution can obviously reduce cardio-pulmonary bypass relative inflammatory response.