胎羊心脏介入手术血气值及血浆细胞因子变化研究

The Changes of Blood Gas and the Concentration of Inflammatory Cytokines During the Intrauterine Cardiac Intervention Surgery

目的观察胎羊宫内心脏介入手术胎羊血气及血浆炎性细胞因子的变化。方法 8只怀孕双胎山羊,双胎之一为实验组,在相同麻醉条件下,实验组进行胎羊心脏介入治疗,并抽取血样标本。监测胎羊的心率、血气、乳酸值,运用ELISA法检测治疗组及对照组胎羊白介素(IL)-1、IL-6、IL-8及肿瘤坏死因子(TNF-α)。结果 2只胎羊因手术中发生心包填塞死亡,存活的6只胎羊手术前pH值较手术后有明显下降(P<0.05),手术前后乳酸浓度上升(P<0.05),PCO2、PO2差异无统计学意义(P>0.05),手术前血浆IL-1、IL-6、IL-8的浓度较手术后高(P<0.05),手术前后TNF-α的浓度变化无统计学意义(P>0.05)。结论胎羊宫内心脏介入手术可引起胎羊血浆pH值下降,乳酸浓度上升,及细胞因子IL-1、IL-6、IL-8浓度上升。

Objective To observe the change of blood gas and inflammatory cytokines during intrauterine cardiac intervention surgery on the fetal lambs.Methods Eight pregnant goats with two fetal in each goat were included.With the same anesthesia condition,one of the twin fetus was chose to perform the intrauterine cardiac intervention surgery.The fetal heart beating rate was monitored,and blood samples of the fetus were taken to do the blood gas analysis and to detect the concentration of inflammatory cytokines（IL-1,IL-6,IL-8,and TNF-α）.Results Two of the eight fetal lambs which was died in the operation because of pericardial tapenade.In the other six survived fetus,the PH was lower than after the surgery,and the concentrations of lactic acid,IL-1,IL-6,and IL-8 are higher than after the surgery.There was no significant difference of PCO2,PO2 and TNF-α between before and after the surgery.Conclusion The intrauterine cardiac intervention surgery can make the PH of fetal plasma lower and the concentrations of lactic acid and IL-1,IL-6,IL-8 higher.