摘要
目的 比较心肺转流心脏手术对成人和小儿围术期患者血浆C 反应蛋白 (CRP)及细胞因子TNF α、IL 8、IL 10水平的影响。方法 将择期心脏手术患者 16例分为两组 ,成人组 (A组 ) ,小儿组 (B组 ) ,每组 8例。分别于全麻诱导前 (基础 ,T0 )、主动脉开放后 (T1)、心肺转流停机后 (T2 )、术毕 (T3 )、术后 2 4h(T4)、术后 4 8h(T5)抽取患者中心静脉血 ,采用双抗体放免法定量测定TNF α、IL 8、IL 10的血浆水平 ;采用放射免疫分析法定量测定CRP血浆水平。结果 组间比较A组和B组TNF α在T0 、T1、T2 、T4、T5血浆浓度相比差异无显著性 (P >0 0 5 ) ,而在T3 ,A组显著高于B组。CRP在T0 、T1、T2 、T3 、T4时 ,A组与B组比较差异没有显著性 (P >0 0 5 ) ;而在T5A组血浆浓度高于B组 ,差异具有显著性 (P <0 0 5 )。IL 8血浆浓度在T2 、T3 时 ,A组低于B组差异具有显著性 (P <0 0 5 ) ;IL 10血浆浓度A组和B组比较 ,差异无显著性 (P >0 0 5 )。组内比较A、B两组内TNF α、IL 10所测血浆浓度值和T0 相比差异无显著性 (P>0 0 5 )。CRP在A组和B组中T4和T5均较T0 升高 (P <0 0 5 ) ;IL 8在A组和B组中T1、T2 、T3 、T4、T5时均较T0 增高 (P <0 0 5 )。结论 心肺转流心脏手术所诱发的组织炎性反应小儿强于成人。
Objective To compare effects of cardiac surgery with cardiopulmonary bypass on serum level of CRP and cytokines in adults and children. Methods Prospective, randomized, double-blind study design was employed. 16 patients scheduled for cardiac surgery with CPB were divided into two groups: group A, n =8; group B, n =8. The standardized anaesthetic included fentanyl, vecuronium and midazolam. Blood samples for cytokines and CRP measurements were collected into EDTA-Vacutainers from central vein at the following time: just prior to induction of anesthesia (baseline, T 0), 5 min after aortic cross-clamp release (T 1), 5 min after weaning from CPB (end-CPB, T 2), on completion of surgery (T 3), 24 hours (T 4) and 48 hours(T 5) after the operation. Concentrations of CRP, TNF-α, IL-8, and IL-10 were measured by radio immunoassay (RIA). Results No significant rise occurred in TNF-α, IL-10 in both groups except a significant reduction in T 3 in group B. Patients in group A had significant rises in T 5 CRP and significant reduction in T 3, T 4 IL-8 compared with group B ( P <0 05). Patients in group A and group B had significant rise in T 4, T 5 CRP, T 1~5 IL-8 compared with the baseline of each ( P <0 05). Conclusion Systemic inflammatory response in children undergone cardiac surgery with CPB is more severe than that in adults.
出处
《安徽医科大学学报》
CAS
2004年第1期66-68,共3页
Acta Universitatis Medicinalis Anhui
基金
安徽省科技厅重点科研项目 (编号 :0 10 41182 )