心肺转流术后持续利尿对全身炎症反应的影响

Effects of sustained diuresis on systemic inflammatory response after cardiopulmonary bypass

目的探讨持续利尿对心肺转流(CPB)术后24h内血和尿中TNF-α、IL-6和IL-8浓度的影响。方法 40例行CPB心脏手术的患者分均为两组:试验组持续静脉应用呋塞米利尿;对照组间断应用呋塞米。ELISA法检测术前和术后2、6、12和24h两组患者血和尿中的TNF-α、IL-6和IL-8浓度。结果术后12和24h,试验组血TNF-α和IL-8增长率低于对照组(P<0.01),而尿TNF-α和IL-8增长率高于对照组(P<0.05)。结论术后持续利尿可有效降低CPB患者血TNF-α、IL-6和IL-8增长率。

Objective To observe the effects of continuous dieresis on serum and urine concentrations of TNF-α,IL-6and IL-8in the patients underwent cardiopulmonary bypass（CPB）.Methods Forty patients underwent cardiac surgery under CPB were equally randomized into two groups of A（treated with continuous diuresis with furosemide）and C（treated with intermittent use of furosemide）.The concentrations of TNF-α,IL-6and IL-8in serum and urine were detected by ELISA before and at 2,6,12 and 24hours after surgery.Results The increase rates of serum concentrations of TNF-α,IL-6and IL-8at 12 and 24hours after surgery were lower（P〈0.01）,but those of urine concentrations of TNF-α,IL-6and IL-8 were higher,in group A than those in group B（P〈0.05）.Conclusion Continuous diuresis with furosemide is able to reduce effectively the increase rate of serum TNF-α,IL-6and IL-8in the patients after CPB.