亚低温对心肺复苏后急性肺损伤的研究

Influence of mild therapeutic hypothermia in acute lung injury after successful resuscitation from cardiac arrest

目的通过测定亚低温下心肺复苏后患者肺内TNF-α、IL-8的含量变化,初步探讨亚低温能否减轻缺血再灌注损伤导致的急性肺损伤。方法将20例心跳骤停、心肺复苏后患者随机分成亚低温组和治疗组,检测患者2、12、24、48、72、92h及120h肺泡灌洗液内TNF-α和IL-8含量。结果心肺复苏后常规组患者TNF-α在各时点呈先升后降,24h达最高峰,之后下降,亚低温组各时点肺泡灌洗液内TNF-α含量明显低于较常规组,且有统计学意义(P<0.05)。IL-8含量在常规组和亚低温组皆呈上升趋势,但亚低温组在各时点含量显著低于常规组(P<0.05)。结论亚低温治疗能显著降低心肺复苏后患者肺内的TNF-α、IL-8含量,一定程度上减轻肺内炎症变化,降低ALI的发生率及减轻严重程度。

Objective To determine tumor necrosis factor-alpha（ INF-α） and interleukin-8（ IL-8） in pulmonary after cardiopulmonary resuscitation ,and evaluate if hypothermia affects acute lung injury after successful cardiopulmonary resuscitation. Methods A total of 20 patients were enrolled. they were randomized to receive mild hypothermia groups or normal control groups,BALF samples were analyzed for levels of interleukin 8,tumor necrosis factor-alpha,after hospital admission 2 hours and after 12,24,48,72,92and 120 hours. Results Regardless of outcomes,interleukin 8 and tumor necrosis factor-alpha levels were significantly elevated by the use hypothermia （ n = 20,P〈 0. 05）. Compare with normal control groups the expressions of TNF-a and IL-8 were significantly lower in hypothermia groups,and lung injury Was less sever. Conclusion In this observational study,hypothermia influenced the inflammatory response after cardiopulmonary resuscitation and decrease the severity of lung injury to some extent.