自体肺体外循环对犬体外循环相关性炎症反应的影响  

Effect of extracorporeal circulation with autologous lung as oxygenator on CPB-relative inflammatory response

作　　者：林柏松[1] 张秀和[1] 张柏民[1] 姜亦忠[1] 李哲[1] 施凯耀[1] 

机构地区：[1]吉林大学中日联谊医院心脏外科,吉林长春130033

出　　处：《吉林大学学报（医学版）》2010年第1期104-107,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科技发展计划项目资助课题(20080742)

摘　　要：目的:探讨以自体肺取代人工肺的体外循环(CPB)方法对犬体外循环相关性炎症反应的影响,阐明其作用机制。方法:12只杂种犬随机分为对照组和实验组(每组6只)。对照组在CPB期间使用膜式氧合器,实验组在CPB期间使用自体肺进行氧合,两组均阻断主动脉90min、辅助循环30min,于CPB前(T1)、转流后60min(T2)、停机后60min(T3)、停机后120min(T4)抽取动脉血,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)含量。结果:对照组和实验组犬血浆TNF-α、IL-6和IL-10水平在T2～T4各时点与体外循环前比较均明显增加(P<0.01);T2～T4时点实验组犬血浆TNF-α和IL-6水平明显低于对照组(P<0.01),IL-10水平明显高于对照组(P<0.05)。结论:自体肺体外循环可抑制犬CPB过程中促炎细胞因子TNF-α和IL-6的释放,促进抗炎细胞因子IL-10的释放,提示自体肺CPB可减轻常规CPB引起的全身炎症反应。Objective To determine the protective effect of cardiopulmonary bypass （CPB） with autologous lung as oxygenator on CPB-relative inflammatory response. Methods Twelve adult mongrel dogs were randomly divided into control group and experimental group. CPB using a membrane oxygenator （control group） or using the autologous lung （experimental group） for gas exchange was performed for 120 min in an alternating Series of 12 mongrel dogs with 90 min heart arrest by crystalloid cardioplegia and 30 min reperfusion. The blood samples were collected at the same time point of pre operation （T1）, 60 minofCPB （T2）, and 1 h （T3）, 2 h （T4） after CPB. The plasma levels of IL-6, IL-10, TNF-α were detected with ELISA. Results The plasma levels of IL -6, IL-10 and TNF-α of dogs in each group were significantly increased at T2, T3 and T4 （P〈0.01） compared with before CPB. The plasma levels of IL -6 and TNF-α in experimental group were significantly lower than those in control group at T2, T3 and T4 （P〈0. 01）. The plasma levels of IL -10 in experimental group were significantly higher than those in control group at T2, T3 and T4 （P〈 0.05）. Conclusion Extracorporeal circulation with autologous lung as oxygenator could reduce the increased amplitude of the plasma levels of TNF-α and IL-6, whereas enhance the increased amplitude of the plasma IL-10 level. The results indicate that extraeorporeal circulation with autologous lung as oxygenator can reduce the CPB relative inflammatory respones.

关 键 词：自体肺 炎症反应 细胞因子 体外循环 

分 类 号：R-332[医药卫生] R654.1