体外循环开心手术围术期血清细胞因子水平的变化

Serum Cytokine Levels Change of Periintracardiac Surgery under Extracorporeal Circulation

目的 了解体外循环下开心手术围术期血清细胞因子的变化规律及其作用。方法 选择12例体外循环下瓣膜置换术病人 ,在体外循环开始后 5min ,主动脉开放前 5min ,主动脉开放后5min、1h、2h、12h、3 6h采静脉血。应用单克隆抗体酶联免疫法测定肿瘤坏死因子α、白细胞介素 8、白细胞介素 10、巨噬细胞集落趋化因子及白细胞、血小板计数进行比较和相关分析。结果 肿瘤坏死因子α峰值出现在体外循环开始后 5min ,炎症因子白细胞介素 8和抗炎症细胞因子白细胞介素 10均在主动脉开放后 1h达峰值 ,巨噬细胞集落趋化因子在主动脉开放后 3 6h达峰值。结论 血清细胞因子在体外循环过程中和其后的机体炎症反应 ,防御修复及造血各方面发挥着重要作用。

Objective To investigate the serum cytokine levels changes of and the effects of the serum cytokines of extracorporeal circulation.Methods At 5 minutes after extracorporeal circulation start, 5 minutes before aortic opening, 5 minutes,1 hour, 2 hours,12 hours, 36 hours after aortic opening, the tumor necrosis factor α(TNF-α),interleukin-8 (IL-8), interleukin-10 (IL-10), Macrophage colony stimulating factor (MCSF),white blood cell (WBC),platelet (Plt) in 12 adult patients who underwent mitral and/or aortic valve replacement were measured. Results The highest level of the TNF-αwas observed 5 minutes after the extracorporeal circulation start, the highest level of the IL-8 and IL-10 were observed 1 hour after aortic opening, MCSF increased gradually in the late post-extracorporeal circulation phase and reached a peak an 36 hours after aortic opening. Conclusion Serum cytokines might play an important role in inflammation, rehabilitation and regulating hematopoiesis during and after extracorporeal circulation.The therapy based on the kinetics of these cytokines would be useful for patients undergoing extracorporeal circulation.