银杏叶提取物对体外循环心内直视手术患者血浆S100-β蛋白及炎性细胞因子的影响  

Cerebral protective effects of Ginko biloba extract Ginaton on S100-β protein and inflammatory cell factors in open cardiac surgery under hypothermic cardio-pulmonary bypass

作　　者：邓云坤[1] 韦方[2] 安邦权[3] 张大国[4] 许进福[5] 

机构地区：[1]贵州省人民医院麻醉科,贵阳550002 [2]贵州省人民医院心内科,贵阳550002 [3]贵州省人民医院检验科,贵阳550002 [4]贵州省人民医院心外科,贵阳550002 [5]贵州省人民医院药剂科,贵阳550002

出　　处：《贵州医药》2009年第4期295-298,共4页Guizhou Medical Journal

基　　金：贵州省优秀科技教育人才省长专项资金项目(NO:黔省专合字[2005]34);贵州省中医药管理局资助项目(NO:2004-1)

摘　　要：目的探讨银杏叶提取物(金纳多)对体外循环(CPB)心内直视手术患者血浆S100-β蛋白水平及炎性细胞因子TNF-α、IL-6、IL-10的影响。方法择期CPB下行心内直视单纯二尖瓣置换术病人60例,ASA Ⅱ～Ⅲ级,男35例,女25例,年龄34.5～57.5岁。全身静脉麻醉后,按随机数字表法随机分为两组(n=30),银杏组:纵断胸骨之前给予银杏叶提取物(金纳多)1mg/kg,静脉滴注,CPB开始前滴完;对照组:以等量生理盐水同速度静脉滴注。分别于转机前(T1)、转机30min(T2)、停机即刻(T3)、停机后60min(T4)、停机后24h(T5)5个时点采中心静脉血液10mL离心,用ELISA法测定血浆中S100-β蛋白、TNF-α、IL-6、IL-10。结果T1时两组S100-β蛋白、TNF-α、IL-6、IL-10差异无统计学意义(P>0.05)。S100-β蛋白、TNF-α、IL-6:两组T2、T3及T4时较T1增高(P<0.05或P<0.01),银杏组升高的幅度低于对照组(P<0.05或P<0.01)。IL-10:两组T2、T3、T4时较T1升高(P<0.05或P<0.01),银杏组升高的幅度高于对照组(P<0.05或P<0.01)。结论银杏叶提取物(金纳多)可通过抑制炎症反应、调节促炎因子/抗炎因子之间的平衡,从而降低转流过程中及转流后血浆S100-β蛋白水平。Objective To investigate the cerebral protective effects of Ginko biloba extract Ginaton on S100-β protein and inflammatory cell factors in open cardiac surgery under hypothermic cardiopul- monary bypass （CPB）. Methods Sixty ASA Ⅱ-Ⅲ rheumatic heart disease patients undergoing elective mitral valve replacement operation were randomly divided into two groups. Ginaton group （30 patients）, Ginaton （1mg/kg） were infused before CPB. Control group （30 patients） with normal saline. MAP was maintained at 60-70mmHg during CPB. Hematocrit was maintained at 18%-22%. Changes of plasma S100-β protein, tumor necrosis factor-alpha （TNF-α）, interleukin-6 （IL-6） and interleukin-10（IL-10） were measured by using the ELISA technique before （T1）, 30 min of CPB （T2）, termi- nation of CPB （T3） ,60 min after CPB （T4）, and 24h after CPB （T5）. Results The two groups were comparable with respect to demographic data, CPB time and duration of operation. S100-β protein, TNF-α,and IL-6 were increased at T2, T3 and T4 as compared to the baseline （T1） in both groups and were significantly lower in Ginaton group than in control group （P〈0. 05 or P〈0. 01）. The IL-10 was increased at T2, T3 and T4 as compared to the baseline （T1） in both groups and were significantly higher in Ginaton group than in control group （P〈0. 05 or P〈0. 01）. Conclusion Ginko biloba extract Ginaton can decrease the S100-β protein levels through inhibited the inflammatory response and adjusted the balance of the proinflammatory factor and inhibit-inflammatory factor during CPB and open cardiac surgery.

关 键 词：银杏叶提取物 心肺转流术 S100-Β蛋白 脑保护 炎性细胞因子 

分 类 号：R654.1[医药卫生—外科学]