心肺复苏病人脑缺血-再灌注损伤后炎性细胞因子的监测及其意义

Observation on inflammatory cytokines in patients of cardiopulmonary resuscitation following cerebral ischemia-reperfusion injury and their significance

目的 探讨炎性细胞因子 [肿瘤坏死因子 (TNF -α)、白细胞介素 - 1β(IL - 1β)和白细胞介素 - 8(IL - 8) ]在心肺复苏 (CPR)病人脑缺血—再灌注损伤中的作用。方法 选择我科CPR病人基础生命支持 (BLS)后 11例 ,采用颈内静脉穿刺导管留置采血 ,动态监测颈内静脉血 (BjV)及外周静脉血 (BpV)中TNF -α、IL - 1β、IL - 8含量变化。 结果 TNF -α、IL - 1β、IL- 8在颈内静脉血、外周静脉血中先后增加 ,并持续 5d ,但前者比后者高 (有显著差异 ) ,且出现时间早。结论 炎性细胞因子参与了心肺复苏时脑缺血—再灌注损伤的发生发展过程 ;干预这些炎性细胞因子将会减轻脑缺血—再灌注损伤的急性炎症反应 。

Objective To explore the role of inflammatory cytokines in patients of cardiopulmonary resuscitation (CPR) following cerebral ischemia-reperfusion injury.Methods 11 patients of CPR following BLS in my department were diserved.By using technique of jugular catheterization and blood sampling,the changes in levels of tumor necrosis factor-α(TNF-α),Interleukin-1 β(IL-1 β)and IL-8 in jugular vena(JV) and peripheral vena(PV) were observed.Results The levels of TNF-α,IL-1 β and IL-8 in JV and PV were sequentially increased and maintained at high levels for 5 days.But the levels of them in JV were higher and earlier than in PV.Conclusions The inflammatory cytokines participate in the onset and development of cerebral ischemia-reperfusion of CPR.Interfering these inflammatory cytokines will relief acute inflammatory reactions of cerebral ischemia-reperfusion injury and raise chance of success of resuscitation.