缺血预处理对瓣膜置换术患者细胞因子水平的影响  

Effects of Ischemic Preconditioning on Plasma Levels of Cytokines in Patients of Cardiac Valve Replacement

作　　者：王湘[1] 张希[2] 陈振光[2] 姚尖平[2] 熊迈[2] 许哲[2] 王志平[2] 

机构地区：[1]孙逸仙心血管医院心外科,广东深圳518020 [2]中山大学附属第一医院心外科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2009年第1期96-99,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2007B080701039)

摘　　要：【目的】研究缺血预处理(IPC)对瓣膜置换术患者细胞因子水平的影响,并探讨其机制。【方法】24例瓣膜置换手术患者,随机分为对照组(10例)和预缺血组(14例),比较两组患者细胞因子IL-6、IL-8和白细胞总数、中性粒细胞的变化。【结果】IL-6和IL-8在主动脉开放5min时已升高;术后1d时,预缺血组IL-6和IL-8明显低于对照组(P<0.05),术后3d时预缺血组IL-8即恢复至术前水平且低于对照组(P<0.05)。预缺血组白细胞总数在术后1～3d明显低于对照组(P<0.05),中性粒细胞在术后1d明显低于对照组(P<0.05)。【结论】IPC并没有减轻术中IL-6和IL-8的释放,但明显减轻了术后1～3dIL-6和IL-8的释放,IPC的迟发性保护作用可能与炎性细胞因子释放减少有关。[Objective] To study the effect of iscbemic preconditioning （IPC） on the systematic cytokine during and after the valve replacement operation and to investigate the mechanism. [Methods] Twenty-four patients were randomly divided into control group （n = 10） and IPC group （n = 14）. The levels of IL-6 and IL-8 and the number of leucocytes and neutroeytes were measured. [Results] The levels of IL-6 and IL-8 increased significandy 5 rain after the declamping of aorta in both groups. However, they were significantly lower in IPC group on the 1st day after operation （P 〈 0.05）. IL-8 in IPC group retufiaed to the preoperative level but was lower than that in the control group on the 3rd day after operation （P 〈 0.05）. The total leukocyte count between the 1st and 3rd day （P 〈 0.05） and the number of neutrocytes on the 1st day （P 〈 0.05） of post operation in IPC group were low compared with that in control group. [Conclusion] IPC does not decrease the release of cytokine IL-6 and IL-8 during the operation but between the 1st and 3rd day of post operation. The delayed protective effect of IPC may be related to the reduced release of inflammatory cytokines.

关 键 词：缺血预处理 瓣膜置换术 细胞因子 

分 类 号：R654.2[医药卫生—外科学]