乌司他丁对体外循环心脏手术病人脑内IL-6和IL-8的影响  

Effect of ulinastatin on cerebral inflammatory response in patients undergoing cardiopulmonary bypass

作　　者：刘瑶[1] 陈江辉[1] 李友清[1] 郭曲练[1] 

机构地区：[1]中南大学湘雅医院麻醉科,湖南长沙410008

出　　处：《中国现代医学杂志》2005年第9期1389-1391,共3页China Journal of Modern Medicine

摘　　要：目的研究乌司他丁(Ulinastatin)对体外循环(CPB)心脏手术患者脑内IL-6和IL-8的影响。方法择期心脏手术病人20例随机分为对照组(C组,n=10)和ulinastatin组(U组,n=10)。U组在CPB机预充液中加入30万u乌司他丁,分别于切皮前(T1)、CPB前(T2)、主动脉开放心脏复跳后5min(T3)和关胸后10min(T4)抽动脉血和右颈内静脉球部血,测定致炎性细胞因子IL-6和IL-8水平。结果在CPB后,两组病人动脉、颈静脉球部血IL-6和IL-8水平较CPB前明显增高(P<0.05),且颈静脉球部血IL-6和IL-8水平明显高于组内同时点动脉血(P<0.05)。与C组比较,CPB后U组动脉血IL-6和IL-8水平明显降低(P<0.05),而颈静脉球部血IL-6和IL-8水平降低更明显(P<0.01)。C组1例病人术后早期出现逆行性遗忘,U组无1例发生精神障碍。结论乌司他丁在减轻全身炎性反应的同时,也能抑制CPB后脑内促炎性细胞因子的过度诱导,从而可能对CPB后的脑损伤有预防作用。[Objective]To investigate the effects of ulinastatin on cerebral inflammatory response in patients undergoing cardiopulmonary bypass. Twenty ASA Ⅲ, Ⅳ patients undergoing elective heart surgery were randomly divided into a control group(group C, n =10)and an ulinastatin group(group U, n =10), In group U, We introduced 300,000 units of ulinastatin into a priming solution for cardiopulmonary bypass. Blood samples were taken from artery and right jugular blub simultaneously before operation, before CPB, 5min after removal of aortic cross-clamping and 10min after the thoracic cavity closed for determination of interleukin-6 (IL-6) and interleukin-8 (IL-8). In all patients the artery and jugular blub blood levels of IL-6, IL-8 after CPB were significantly higher than baseline (before CPB) and the post-CPB jugular blub blood levels of IL-6, IL-8 significantly higher than those in artery. In group U, the post-CPB jugular blub blood levels of IL-6, IL-8 were significantly lower than those in group C. In group C, one patient had reteograde amnesia after the operation. [Conclusions] Ulinastatin may inhibit overinduction of brain inflammatory cytokines and it maybe correlate with attenuating the postoperative brain injury.

关 键 词：体外循环 炎性因子 乌司他丁 脑 

分 类 号：R614.1[医药卫生—麻醉学]