体外循环致先天性心脏病手术患者血液细胞因子水平的变化  

The Changes of Cytokines Levels Related to Cardiopulmonary Bypass in Patients Undergoing Surgery for Congenital Heart Defects

作　　者：肖锡俊[1] 章崇杰[1] 赵宗蓉[1] 张平[1] 杜晓东[1] 李勇[1] 王允[1] 袁宏声[1] 

机构地区：[1]华西医科大学附属第一医院胸心外科

出　　处：《中国胸心血管外科临床杂志》1998年第1期14-17,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：纽约中华医学基金

摘　　要：目的探讨体外循环对先天性心脏病手术患者外周血细胞因子水平的影响。方法以先天性心脏病手术患者为研究对象，不需体外循环的心血管手术患者作为对照，酶联免疫吸附法和生物活性法测定手术前、中、后多时间点外周血中细胞因子水平。结果二组患者术中和／或术后白细胞介素－２明显降低（Ｐ＜０．０５）；可溶性白细胞介素－２受体、白细胞介素－６、肿瘤坏死因子－α和白细胞介素－１０明显升高（Ｐ＜０．０５）。结论手术应激和体外循环均是引起先天性心脏病患者术中和／或术后细胞因子水平改变的主要因素。Objective To examine the effect of cardiopulmonary bypass(CPB) on cytokines levels of peripheral blood in patients undergoing surgery for congenital heart defects. Methods The possible differences between patients undergoing surgery for congenital heart defects(CPB group, n=10) and those receiving closure of patent ductus arteriosus or pericardiectomy(no CPB group, n=9) were evaluated. Venous blood levels of interleukin 2(IL 2),soluble interleukin 2 receptor(sIL 2R),interleukin 6(IL 6),tumor necrosis factor α(TNF α), and interleukin 10(IL 10) were measured by means of biological activity assay or enzyme linked immunosorbent assays at multiple time points before, during, and after operation. Results As compaired with pre operative values, IL 2 levels decreased significantly in both groups ( P <0.05), and the levels of sIL 2R, IL 6, TNF α, IL 10 increased significantly in both groups at multiple time points after operation( P <0.01). Although there were no pre operative differences in these cytokines between the two groups( P >0.05), the post operative changes of cytokines in CPB group was more obvious than that in no CPB group( P <0.01). There also was a preceding IL 10 peak value, as compared with the peak values of IL 6 and TNF α in CPB group. Conclusion The results suggest that besides surgical stress mediated cytokines respones, CPB itself also results in obvious changes of cytokines metabolism.

关 键 词：先天性心脏病 体外循环 细胞因子 

分 类 号：R654.1[医药卫生—外科学] R541.1[医药卫生—临床医学]