利多卡因对室间隔缺损修补术体外循环过程炎症反应的影响  

Influence of lidocaine on systemic inflammation in perioperative patients undergoing cardiopulmonary bypass

作　　者：孙传彬[1] 陈立波[1] 程颖[1] 冯刚[1] 张卫星[1] 

机构地区：[1]北京大学深圳医院心外科,深圳518036

出　　处：《北京大学学报（医学版）》2005年第6期622-624,共3页Journal of Peking University:Health Sciences

摘　　要：目的探讨室间隔缺损修补术患者围术期的炎性反应及利多卡因对其的影响。方法20例心功能Ⅱ级的室间隔缺损修补术患者,随机分为利多卡因组和空白对照组,利多卡因组于复跳前给予利多卡因1mg/kg。分别于麻醉诱导后(T1)、体外循环结束后30min(T2)、体外循环结束后2h(T3)、体外循环结束后4h(T4)于中心静脉采取静脉血,常规法测定白细胞(WBC)、中性粒细胞(PMN)、中性粒细胞百分比(PMN%);放射免疫法测定IL-6、IL-8。结果两组T2～T4WBC、PMN、IL-6及IL-8明显升高;IL-6及IL-8在T2达峰值;利多卡因组显著低于空白对照组。结论体外循环下室间隔缺损修补术可导致较强而短暂的炎性反应,于体外循环后30min达高峰并持续至体外循环结束后4h;利多卡因对此炎性反应具有平抑作用。Objective： To investigate the influence of lidoeaine o,1 systemic inflammation in the perioperative ventricular septal defect （VSD）. Methods： Twenty patients, scheduled for ventricular septal defect were randomly divided into 2 groups： lidoeaine and control groups. Before rebeat lidocaine 1 mg/kg was given. The venous blood samples were obtained from the central venous at the following points： after induction of anesthesia and before cardiopulmonary hypass（ CPB,TI ）, 1 h after CPB（T2） ,2 h after CPB （T3）, and 4 h after CPB（T4）. IL-6 and IL-8 were determined by radio-immunoassay. Results： Compared with those at TI, the levels of white blood cells, polymorphonuclear neutrophils,IL-6 and IL-8 increased significantly from T2 to T4 in both groups. 1L-6 and IL-8 levels reached the peak at T2. Compared with those in control groups, IL-6 level decreased ohviously in lidocaine group from T2 to T4, but IL-8 level remained unchanged significantly. Conclusion： Under CPB and VSD repair the systemic inflammation is obvious, reaches the peak 30 min after CPB and persists to 4 h after CPB. Perioperative administration of lidocaine is effective against the inflammation.

关 键 词：室间隔缺损 体外循环 利多卡因 炎症 

分 类 号：R541.1[医药卫生—心血管疾病]