改良LPD肺动脉灌注对体外循环术后全身炎症反应的影响  

Effect of Pulmonary Artery Perfusion with Modified LPD Solution on Cardiopulmonary Bypass-induced Systemic Inflammatory Response

作　　者：刘立明[1] 胡建国[1] 尹邦良[1] 周新民[1] 杨进福[1] 宋国宝[1] 李李[1] 

机构地区：[1]中南大学湘雅二医院胸心外科,湖南长沙410011

出　　处：《中国医师杂志》2005年第8期1048-1050,共3页Journal of Chinese Physician

基　　金：湖南省卫生厅科研基金资助课题(B2004-048)

摘　　要：目的研究体外循环(CPB)期间改良低钾右旋糖酐(LPD)溶液肺动脉灌注对CPB术后全身炎症反应的影响。方法30例行二尖瓣置换术病人随机分为肺灌注组15例,对照组15例。肺灌注组病人CPB术中一次性肺动脉灌注低温改良LPD液,对照组常规行二尖瓣置换术。分别于术前、术后0h、6h抽取病人静脉血,采用双抗体夹心ABC-ELISA法测算TNF-、IL-8血浆浓度。结果同组术后与术前比较均有明显升高(P<0·05);改良LPD灌注组与对照组比较,术后0h、术后6hTNF-α与IL-8血浆浓度有显著降低(P<0·05)。结论CPB心脏手术可引起术后细胞因子TNF-α、IL-8水平的升高,CPB中改良LPD肺动脉灌注可降低术后TNF-α、IL-8水平,具有抑制CPB所致全身炎症反应的效果。Objective To study the effect of pulmonary artery perfusion with the modified low- potassium dextran（LPD） solution on cardiopulmonary bypass（CPB） - induced systemic inflammatory response. Methods 30 patients undergoing mitral valve replacement were randomly divided into control group （ n = 15） and lung perfusion group （ n = 15）, The patients in the lung peffusion group were perfused with the modified LPD solution by pulmonary artery during CPB. The patients in the control group underwent the routine procedure of mitral valve replacement. Theplasma concentrations of TNF - ct and IL - 8 were measured before and 0 h, 6 h after surgery by ABC - ELISA. Results The plasma levels of TNF-α and IL - 8 significantly increased after surgery in beth groups. The plasma levels of TNF - α and IL - 8 were significantly lower（ P 〈 0.05）at 0 h, 6 h after surgery in lung perfusion group than that in control group. Conclusion CPB could induce the increase of TNF - α and IL - 8 levels after surgery. Pulmonary artery perfusion with the modified LPD solution during CPB could decrease the levels of postoperative plasma TNF -α and IL- 8, and inhibit CPB - induced systemic inflammatory response.

关 键 词：改良LPD肺动脉灌注 体外循环 术后 全身炎症反应 

分 类 号：R654.1[医药卫生—外科学]