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作 者:赵明霞[1] 龙村[1] 贺学英[2] 管博[2] 王蕊[2]
机构地区:[1]中国医学科学院阜外心血管病医院体外循环科,北京100037 [2]北京凯正生物工程发展有限责任公司,北京100850
出 处:《中国体外循环杂志》2007年第1期43-46,共4页Chinese Journal of Extracorporeal Circulation
基 金:国家863基金(2002AA205101)
摘 要:目的探讨在体外循环(extracorporeal circulation,ECC)预充液中加入聚乙二醇牛血红蛋白偶联物(PEG-bHb)对兔血清炎性因子的影响。方法24只成年健康大耳白兔,通过股动脉、颈静脉插管建立体外循环通路,转流1h。随机分成三组,对照组(n=8),以晶/胶体液作为ECC预充液;实验组1(n=8),在预充液中加入PEG-bHb,PEG-bHb占总容量(兔循环血量+预充量)的5%;实验组2(n=8),预充液中加入PEG-bHb,占总容量(兔循环血量+预充量)的15%,ECC开始时放出自体血(放血量占兔循环血量的20%),ECC结束后将自体血回输。每组监测ECC前、中和ECC后的血气参数,用ELISA法测定各时间点血清白介素-6(IL-6)、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)浓度。结果三组在ECC后各时间点的炎性因子无显著差异,但实验组2在ECC后各时间点的炎性指标较对照组相比有下降的趋势。结论血液代用品PEG-bHb单纯用于预充对兔ECC后炎性反应无影响,用PEG-bHb置换自体血有可能减轻兔ECC后炎性反应。OBJECTIVE To investigate the effect of PEG - conjugated bovine hemoglobin ( PEG - bHb) on inflammatory factors when added directly to extracorporeal circulation(ECC) prime in anaesthetized rabbit. METHODS 24 anaesthetized rabbits (2.59 ± 0.19 ) kg, connected to ECC by jugular venous and femoral arterial cannulation and bypass for 1 hour, were randomly divided into 3 groups. In control group(n =8), a crystallold/colloid solution was used as prime solution. In experimental group 1 ( n = 8 ), PEG - bHb (5 % total volume) was added to the pump prime of bypass. Total volume is the sum of circulation volume and prime volume. In experimental group 2( n = 8), PEG - bHb ( 15% total volume) was used in the pump prime with previous blood harvesting(20% circulation volume) before ECC. Blood gas were monitored throughout the procedure. The inflammatory factors (IL -6 ,TNF -α, CRP) were measured using ELISA. RESULTS There were no significant difference of IL - 6, TNF - α and CRP between three groups. But in experimental group 2, the inflammatory factors were less than those in control group, but not significantly. CONCLUSION PEG - bHb added to the prime of a rabbit ECC circuit does not independently affect inflammatory response. PEG - bHb on the prime with previous blood harvesting before ECC may improve inflammatory response.
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