腺苷预处理对小儿体外循环肺损伤的保护作用

Protective Effect of Adenosine Preconditioning on Lung Ischemia Reperfusion Injury in Pediatric Patients Undergoing Cardiopulmonary Bypass Operation

目的探讨腺苷预处理对小儿体外循环肺损伤的保护作用及其机制。方法 30例无肺动脉高压室间隔缺损小儿随机分成腺苷组和对照组。腺苷组在麻醉诱导后经颈内静脉插管泵入腺苷,对照组同法注入等体积生理盐水。采桡动脉血测定围手术期中性粒细胞弹性蛋白酶(NE),丙二醛(MDA),白细胞介素-10(IL-10)水平;停体外循环后30min采右上肺组织分别做光镜和透射电镜组织学检查。结果体外循环开始后NE、MDA、IL-10值显著升高,腺苷组NE、MDA低于对照组,而IL-10高于对照组;组织学上腺苷组肺损伤明显轻于对照组。结论腺苷预处理可减轻小儿体外循环肺损伤。

Objective To investigate the protective effect of adenosine preconditioning on ischemic reperfusion （I/R） induced lung injury in pediatric CPB. Methods Thirty pediatric patients undergoing remedy operation for VSD under CPB were preoperatively randomized into an adenosine group and a control group. Adenosine was infused into superior vena cava close to right atrium via internal jugular vein cannula by minipump ;in the control group, the same amount of NS was infused instead of adenosine. In all patients, blood samples were taken from radial artery the blood to determine the serum concentrations of NE, MDA, and IL - 10 at perioperative period. Totally 30 minutes after CPB,right lung biopsy was performanced to observe the histological change under light microscope and transmission electron microscope. Results After CPB,the levels of NE, MDA in group Adenosine were significantly lower than those of control group ; the level of NE IL - 10 in group Adenosine were significantly higher than that of control group ; Adenosine reduces the amount of histological lung injury. Conclusion Adenosine preconditioning can attenuate ischemical - reperfusion lung injury in pediatric patients undergoing cardiopulmonary bypass operation.