红景天对先天性心脏病体外循环术后炎性反应的影响  

Effects of Integripetal Rhodiola Herb on Inflammatory Reaction in Patients with Congenital Heart Disease after Undergoing Cardiopulmonary Bypass

作　　者：魏福岭[1] 张向华[1] 陈翔[1] 吕坤[1] 周启文[2] 张仁福[3] 

机构地区：[1]解放军第309医院心外科,北京市100091 [2]北京安贞医院心外科,北京市100029 [3]沈阳军区总医院心外科,沈阳市110016

出　　处：《中国医院用药评价与分析》2010年第2期154-156,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:通过研究红景天对体外循环(CBP)术前、中、后血浆TNF-α和IL-10的变化,了解红景天对体外循环诱发炎性反应的影响,评估红景天对体外循环术后炎性反应的预防与治疗价值。方法:将538例先心病体外循环心内直视手术患者按双盲法随机分为两组,红景天未干预组(CN)259例,红景天干预组(CI)279例。干预组于术前1天、术中、术后7天连续予以红景天1mg.kg-1.d-1静脉滴注,其余治疗方案两组大致相同。ELISA法测定术前1天,CPB开始后15分钟,停CPB即刻,术后第1天,第3天,第5天血浆肿瘤坏死因子-α和白介素-10的浓度。结果:两组患者在CBP开始后及术后血浆肿瘤坏死因子-α和白介素-10浓度明显高于术前,都存在显著差异(P<0.01);未干预组CBP开始后及术后肿瘤坏死因子-α和白介素-10浓度明显高于干预组,二者存在显著差异(P<0.01);术后两组IL-10/TNF-α比值存在显著变化(P<0.01),IL-10/TNF-α比值,干预组较未干预组恢复早;TNF-α与IL-10之间浓度变化存在正相关(r=0.671,P<0.01)。结论:红景天对炎性因子和抗炎性因子有较好的调节抑制作用,对预防与治疗体外循环所致术后炎性反应有很好的临床实用价值。OBJECTIVE：To investigate the effects of integripetal rhodiola herb on TNF-α,IL-10 and the ratio of IL-10/TNF-α in serum before,during and after undergoing cardiopulmonary bypass （CPB） and on inflammatory reaction induced by CPB,and to evaluate the clinical value of integripetal rhodiola herb in the prevention and treatment of postoperative inflammatory reaction induced by CPB. METHODS： 538 cases with congenital heart disease undergoing open heart surgery with extracorporeal circulation were randomly divided into integripetal rhodiola herb intervention group （group CI,n=279） and non-intervention group （CN,n=259） by double blind method. The intervention group received integripetal rhodiola herb 1 mg·kg^-1·d^-1v gtt from one day prior to operation to 7 days after operation in addition to the therapy for the non-intervention group,while the non-intervention group received no integripetal rhodiola herb. Serum levels of TNF-α and IL-10 were determined by enzyme-linked immunosorbent assay one day prior surgery,15 minutes since the start of CPB,right after the completion of CPB,and at 1,3,5 days after operation,respectively. RESULTS： Serum levels of TNF-α and IL-10 during and after CBP surgery were significantly higher than before surgery （P〈0.01）;in non-intervention group,serum levels of TNF-α and IL-10 during and after CBP surgery were significantly higher than in the intervention group （P〈0.01）. After operation,the TNF-α/IL-10 ratio in both group showed remarkable change （P〈0.01）,with the intervention group showed an early recovery than in the non-intervention group. TNF-α level correlated positively with IL-10 level （r=0.671,P〈0.01）. CONCLUSION： Integripetal rhodiola herb showed remarkable regulating and inhibiting effects on inflammatory factors and anti-inflammatory factors,and it has great clinical value in the prevention and treatment of postoperative inflammatory reactions induced by CPB.

关 键 词：肿瘤坏死因子-α 白介素-10 体外循环(心肺旁路) 红景天 炎性反应 

分 类 号：R932[医药卫生—生药学]