盐酸戊乙奎醚对瓣膜置换术患者体外循环前后白介素及肿瘤坏死因子的影响  

Effects of penehyclidine on cytokines during cardiac valve replacement surgery with cardiopulmonary bypass

作　　者：魏昕[1] 高亚利[1] 秦红[1] 方才[1] 

机构地区：[1]安徽医科大学附属省立医院麻醉科,安徽合肥230001

出　　处：《安徽医科大学学报》2007年第2期208-210,共3页Acta Universitatis Medicinalis Anhui

摘　　要：目的观察盐酸戊乙奎醚对体外循环（CPB）瓣膜置换术患者虹浆炎性因子的影响。方法选择择期体外循环下瓣膜置换术患者20例，随机分为盐酸戊乙奎醚组（A组，n：lO）和对照组（B组，n=10）。A组于CPB前10min静注盐酸戊乙奎醚3mg，对照组给予等量生理盐水。分别于麻醉诱导前（T0）、CPB30min（T1）、主动脉开放后10min（T2）、CPB后3h（T3）、24h（T4）抽取桡动脉血，测定血浆肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、和白细胞介素-10（IL-10）浓度。结果组内比较，B组TNF-α浓度于T3时点高于T0（P〈0．01），而A组T1、T2时点TNF-α浓度较T0显著降低，其余时点与术前比较无明显变化。B组IL-6于T4时点高于A组（P〈0．05），IL-10浓度明显低于A组。组间比较，B组TNF-α浓度于T1-T4各时点均高于A组（P〈0．05）。结论盐酸戊乙奎醚可部分抑制CPB导致的炎性反应，对CPB术后全身炎性反应综合征有一定的预防作用。Objective Inflammation plays a pivotal role in the pathogenesis of organ dysfunction after cardiopulmonary bypass （CPB）. The aim of this study was to investigate the effects of penehyclidine on the inflammatory process and leukocytes in cardiac surgery patients undergoing CPB. Methods A double-blind, prospective, randomized, placebo-controlled study was undertaken to assess the effect of penehyclidine on tumour necrosis factor-alpha（TNF-α）, interleukin-6 （IL-6） and interleukin-10（IL-10） levels in 20 patients undergoing CPB for elective cardiac valve replacement surgery. In 10 patients, 3 mg of penehyclidine was added 10 min before performing CPB;another 10 patients received saline solution as placebo. Results In the control group, IL-6 level at T4 point and TNF-α at T1 - T4 points were significantly higher than that in the study group. IL-10 level at T4 in control group was significantly lower than that of study group. The progressive increment in TNF-α level observed at each point was also significantly prominent in the control group. Conclusion CPB-related whole body inflammatory response could be partially inhibited by intraoperative penehyclidine administration. This effect of penehyclidine may be helpful in preventing the well-known complication of CPB-induced systemic inflammation.

关 键 词：胆碱能拮抗剂/药理学 心肺转流术 白细胞介素类 肿瘤坏死因子 盐酸戊乙奎醚 

分 类 号：R971.92[医药卫生—药品] R654.2[医药卫生—药学]