氯胺酮对婴幼儿体外循环手术患者血浆S-100β和肿瘤坏死因子-α水平影响

Effects of ketamine on concentrations of plasma S-100β and tumor necrosis factor-α after cardiopulmonary bypass in infants

目的探讨婴幼儿体外循环手术中氯胺酮对患者血浆S-100β和肿瘤坏死因子-α的影响。方法 30例拟在体外循环下行心内直视手术的先天性心脏病患儿,随机分为氯胺酮组(K组)与对照组(C组),每组15例。K组转流前经中心静脉泵入氯胺酮1 mg/kg;C组给予等量平衡液。分别于转流前和转流完毕时检测血浆S-100β和肿瘤坏死因子-α水平。结果转流前2组S-100β和TNF-α水平差异无统计学意义(P>0.05);转流后2组S-100β和TNF-α水平均较转流前升高(P<0.05);转流后C组S-100β和TNF-α水平明显高于K组(P<0.05)。结论氯胺酮对体外循环心脏手术诱发的脑损伤中有一定保护作用,其机制可能与抑制内源性炎性因子释放有关。

Objective To investigate the effects of ketamine on plasma S-100β protein and tumor necrosis factor-α after cardiopulmonary bypass in infants.Methods Thirty patients with congenital heart disease received cardiopulmonary bypass.They were randomly divided into ketamine group（group K,n=15） receiving 1 mg/kg ketamine intravenously before cardiopulmonary bypass and control group（group C,n=15） receiving normal saline instead of ketamine.Blood samples from external cycle were collected before the start and after the termination of cardiopulmonary bypass to determine plasma S-100β and tumor necrosis factor-α concentrations,respectively.Results The concentrations of plasma S-100β and tumor necrosis factor-α significantly increased after cardiopulmonary bypass in the two groups（P0.05）.There was no significant difference in the concentrations of S-100β and tumor necrosis factor-α between two groups before the start of cardiopulmonary bypass（P0.05）.After the termination of cardiopulmonary bypass,the concentrations of plasma S-100β and tumor necrosis factor-α were obviously higher in group C than those in group K（P0.05）.Conclusion Ketamine can attenuate cerebral injury in infants undergoing cardiopulmonary bypass,which may be related to the inhibition of the releasing of endogenous inflammatory factors.