白细胞滤器-1对体外循环中白细胞数量、IL-6、MPO水平和心肌病理学变化的影响  

The Influence of Leukocyte Depletion Filter-LD-1 on Leukocytes, IL-6, MPO and the Pathologic Changes of Myocardic Tissues During Cardiopulmonary Bypass

作　　者：朱昭琼[1] 杨亦彬[1] 郑洪[2] 杜磊[1] 邓硕曾[1] 刘进[1] 

机构地区：[1]四川大学华西医院麻醉科 [2]遵义医学院附属医院

出　　处：《四川大学学报（医学版）》2005年第3期429-431,共3页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学青年基金项目 (批准号 3 0 40 0 43 9)资助

摘　　要：目的　研究白细胞滤器(L D- 1)在犬体外循环(CPB)中对白细胞数量、IL- 6、MPO水平和心肌病理变化的影响。方法　对照组犬(n=6 )不使用L D- 1;过滤组犬(n=6 )将L D- 1安装于CPB的静脉回流端。在CPB开始2 m in后打开滤器过滤5 m in。分别于CPB前、CPB10 min、4 0 m in、75 m in、停CPB及CPB后2 h测定血常规、IL- 6和MPO。在CPB前、鱼精蛋白中和肝素5 m in和CPB后2 h取心肌作病理学检测。结果　过滤组白细胞下降到CPB前的36 % ,CPB中低于对照组相同时间点,停CPB后2 h两组均基本恢复至CPB前水平;过滤组IL - 6在CPB后4 0min达到高峰,高于对照组,CPB后2 h明显低于对照组(P<0 .0 5 ) ;CPB期间两组MPO变化和心肌病理学检测无统计学意义。结论　CPB中使用L D- 1能减少白细胞的数量,能阻止或减轻CPB中白细胞介导的炎症反应,而对心肌的病理变化无明显影响。Objective To elucidate the influence of the leukocyte depletion filter(LD-1) on leukocytes, IL-6, myeloperoxidase enzyme(MPO) and the pathological changes of myocardic tissues during cardiopulmonary bypass(CPB). Methods Twelve dogs were used in this study. The LD-1, designed and made by ourselves, was fixed on the venous line in the trial group (n=6). It was used during the first 5 min after 2 min of CPB. LD-1 was not installed in the control group (n=6). Circulating leukocytes were counted before CPB, at 10 min, 40 min, 75 min during CPB, at the end of CPB, and 2 h after CPB. Plasma levels of IL-6 and MPO were also determined at the same time. The pathologic changes of left ventricular biopsies were observed before CPB, 5 min after protamine was given, and 2 h after CPB. Results The CPB 10 min WBC Count fell to 36% of that Before CPB in LD-1 group, which was lower than the WBC count in the control group synchronously (P<0.01). But after CPB 2 h, both of them were close to the levels Before CPB in the two groups. In LD-1 group, IL-6 increased at CPB 40 min and reached to the top. But after wards it dropped continuously. The changes were of no significance in MPO and in the pathological examination of myocardic tissues (P>0.05). Conclusion The LD-1 on venous line was capable of decreasing WBC count effectively. As a result, the inflammation factors that leukocytes released were lower, so the program chain of inflammation by CPB was shorter. But LD-1 was not superior in myocardial preservation.

关 键 词：体外循环 白细胞滤器 炎症 

分 类 号：R654.2[医药卫生—外科学]