围心肺转流期白细胞介素-10的释放与心肺转流炎症反应的关系

Interleukin-10 release during cardiopulmonary bybass and its relationship with systemic inflammatory responses

目的 研究围心肺转流 (CPB)期血浆白细胞介素 1 0 (IL 1 0 )和C 反应蛋白 (CRP)浓度的动态变化及相互关系。方法 1 5例静吸复合全麻下行心内直视手术的病人 ,分别于术前、转流后5min、主动脉开放后 1 0min、2h、术后 8、2 4h取中心静脉血标本 ,以ELISA法检测血浆IL 1 0水平 ,速率散射免疫比浊法测血浆CRP水平。结果 血浆IL 1 0于主动脉开放后 1 0min开始显著升高 (P<0 0 1 ) ,并于开放后 2h达峰值 (P <0 0 1 ) ,术后 2 4h仍高于术前水平 (P <0 0 5 ) ;CRP于术后 8h升至峰值 (P <0 0 1 )。以直线相关分析 ,CPB与IL 1 0峰值浓度呈显著正相关性 (r =0 6 0 ,P <0 0 1 )。结论 围CPB期 ,IL 1 0的释放呈一过性增加 ,并与CPB后炎性反应程度密切相关 ,提示IL 1

Objective To investigate the influence of cardiopulmonary bypass CPB on the release of interleukin 10 (IL 10) and its relationship with the plasma levels of C reactive protein (CRP).Methods The study included 15 patients undergoing open heart surgery under CPB.Blood samples were obtained before operation,at 5min after CPB,at 10min and 2h after aorta declamping,at 8h and 24h after operation.Plasma levels of IL 10 and CRP were measured with ELISA and immunonephelometry respectively.Results Plasma IL 10 levels significantly increased ( P< 0 01)at 10min after aorta declamping and reached its peak (1574 67 ±185 12pg/ml, P< 0 01)after 2h,which remained at a high level 24h after operation ( P< 0 01).Plasma CRP levels rose significantly,peaked at 8h after operation ( P< 0 01).Using linear correlation analysis,peak CRP levels correlated positively with the peak IL 10 levels significantly ( r= 0 60, P< 0 05).Conclusion This study suggested that during and after CPB,in addition to the systemic inflammatory responses to CPB,there is a transient compensatory release of IL 10.The release of IL 10 may represent an endogenous response of limiting the inflammatory responses to CPB. [