乌司他丁对体外循环瓣膜置换术患者围手术期炎性细胞因子水平的影响

Research on effect of ulinastatin on patients' inflammatory factors level during cardiopulmonary bypass valve replacement surgery

目的:分析乌司他丁对体外循环瓣膜置换术患者围手术期炎性因子水平的影响。方法:选取接受体外循环瓣膜置换术治疗的患者92例,并随机分为观察组和对照组,每组46例;分别采用接受乌司他丁治疗和接受等容量生理盐水治疗的方法,检测手术过程中两组患者的炎性因子水平及肺换气功能差异。结果:1于体外循环(CPB)开始后1 h、结束后1 h观察组患者的肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)以及肺泡气-动脉血氧分压差(A-a DO2)水平均低于对照组(t=2.948,t=2.537,t=4.382,t=5.281;P<0.05);2两组患者的A-a DO2水平与TNF-α、IL-6水平呈正相关关系(r2=0.567,r2=0.531;P<0.05)。结论:乌司他丁可以有效降低体外循环瓣膜置换术患者围手术期的炎性因子水平,减少对肺换气功能的影响,且炎性因子水平与A-a DO2水平呈正相关。

Objective： To analyze effect of ulinastatin on patients’ inflammatory factors level during cardiopulmonary bypass valve replacement surgery. Methods： Chosen patients accept cardiopulmonary bypass valve replacement surgery between 2011 to 2013 as research subjects, randomized to receive Ulinastatin as observation group and volume of saline as control group, testing inflammatory levels and pulmonary ventilation function difference. Results： One hour after CPB and 1h after the end of CPB, TNF-α, IL-6 level as well as A-aDO2 level of observation group were lower than control group; （2）A-aDO2 levels were positively correlated with TNF-α, IL-6 levels. Conclusion： Ulinastatin can effectively reduce cardiopulmonary bypass valve replacement surgery preoperative inflammatory cytokine levels, reducing the impact on pulmonary ventilation function, inflammatory levels and pulmonary ventilation function was negatively correlated.