盐酸戊乙奎醚对体外循环下成人心脏手术患者IL-2和IL-10浓度的影响及意义

Effect of Penehyclidine Hydrochloride on the Levels of IL-2 and IL-10 in Patients Undergoing the Operation of Adult Heart Disease Under Cardiopulmonary Bypass and Its Significance

【目的】探讨盐酸戊乙奎醚（PHc）对体外循环下成人心脏手术患者白细胞介素-2（IL-2）和IL-10浓度的影响及意义。【方法】成人择期行体外循环瓣膜置换术患者40例，随机分为PHC组和对照组，每组20例，麻醉诱导前10min分别静注PHC0．02mg／kg和等体积生理盐水，于手术切皮即刻PHC组给予盐酸戊乙奎醚0．02mg／kg，对照组给予同等体积生理盐水。分别在开放静脉前（T1）、手术结束时（T2）、术后24h（T3）、术后48h（T4）采取外周静脉血4mL，用放免法检测血浆白介素IL-2浓度，酶联免疫吸附（ELISA）法检测IL-10，比较两组各时间点血清IL-2、IL-10浓度。【结果】PHC组IL-2、IL-10在T2、T3时显著高于对照组（P〈0．05），T1、T4时两组比较差异无显著性（P〉0．05），两组患者在各时间点的血压（BP）、心率（HR）、脉搏血氧饱和度（SpO2）比较差异无显著性（P〉O．05）。【结论】盐酸戊乙奎醚对体外循环下成人心脏瓣膜置换术患者，有利于保持Th1／Th2型细胞因子平衡，维持机体正常免疫机能。

[Objective]To explore the effect of penehyclidine hydrochloride（PHC） on the levels of interleu- kin-2（IL-2） and interleukin-10（IL-10） in patients undergoing the operation of adult heart disease（ADH） under cardiopulmonary bypass（CPB） and its significance. [Methods]Forty adult patients scheduled for MVR-CPB were randomly divided into PHC group（ n= 20） and control group（group C, n = 20）. PHC 0.02mg/kg and e- qual volume of normal saline were intravenously injected at 10rain before anesthesia induction, respectively. PHC group was given PHC 0.02mg/kg immediately at skin incision of surgery, while group C was given the equal volume of normal saline. Venous blood samples（4mL） were collected before the opening of the vein （T1）, at the end of operation（T2 ）, 24h（T3 ） and 48h（T4 ） after operation. Plasma IL-2 was measured by using radioimmunoassay method. ELISA was used to detect IL-10. Serum levels of IL-2 and IL-10 at each time point were compared between two groups. [Results] IL-2 and IL-10 in PHC group at T2 and Ta were significantly higher than those in group C（ P 〈0.05）, but there was no significant difference at T1 and T4 between two groups（ P 〉0.05）. There was no significant difference in blood pressure（BP）, heart rate（HR） and SpO2 at each time point between two groups（ P 〉0.05）. [Conclusion]PHC is benefit to retain the balance of Thl/ Th2 type cytokines and maintain the normal immunologic function of the patients undergoing the operation of ADH under CPB.