心脏不停跳技术对婴幼儿室间隔缺损机体炎症介质浓度的影响

Beating heart affect inflammatory mediators in the infants undergoing ventricular septal defect surgery

目的观察心脏不停跳技术对婴幼儿室间隔缺损机体炎症介质白介素6(IL-6)和IL-8浓度的影响,评估其临床应用价值。方法 40例择期行室间隔缺损手术患儿,随机分为心脏停跳与心脏不停跳两组,分别于开胸前、体外循环开始、体外循环结束、术后4 h及24 h采集中心静脉血样本,观察5个时点两组IL-6及IL-8在血浆中的浓度变化。结果两组患儿血浆IL-6、IL-8浓度均于开胸前最低,体外循环开始后即开始增高,其中IL-6水平于术后4 h达到峰值,而IL-8浓度则于体外循环结束时达到峰值,随后两者均出现显著下降,且心脏停跳组患儿血浆IL-6和IL-8浓度变化显著高于心脏不停跳组(P<0.05)。结论心脏不停跳修补室间隔缺损是更为合理的手术方式。

Objective To obervate inflammatory mediators interleukin 6（IL-6） and IL-8 concentration in the body of infants with ventricular septal defect in the beating heart,and to evaluate the value of clinical applications.Methods Forty children with ventricular septal defect surgery were randomized to be operatied with aortic blocking or not blocking,IL-6 and IL-8 levels were measured in the venous blood.Samples were taken before openning chest（T0）,cardiopulmonary bypass beginning（T1）,after cardiopulmonary bypass（T2）,postoperative 4 h（T3）and 24 h（T4）.Results IL-6 and IL-8 levels in the venous blood increased at T1 in both groups,IL-6 peaked at T3,IL-8 peaked at T2,then both decreased significantly,IL-6 and IL-8 levels in the aorta blocking group changed significantly higher than those in the aorta not blocking group（P0.05）.Conclusion The beating heart is more reasonable operation method.