经白细胞滤器过滤后的体外循环余血回输对患者炎性细胞因子的影响  

Effect of reinfusion of the remaining blood filtered by leukocyte filter after cardiopulmonary bypass on inflammatory cytokine in patients

作　　者：李景文[1] 龙村[1] 孙鹏[1] 刘凯[1] 考力[1] 

机构地区：[1]中国医学科学院阜外心血管病医院体外循环科,北京100037

出　　处：《中国体外循环杂志》2010年第2期94-96,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的研究白细胞滤器过滤体外循环(CPB)后余血回输对患者白细胞(WBC)数量、白细胞介素(IL)-6、IL-8和肿瘤坏死因子-α(TNF-α)水平的影响。方法 40例择期瓣膜置换术患者,随机分成CPB后余血回输过滤组(n=20)和对照组(n=20)。分别检测CPB余血回输前、CPB余血回输完成后1 h、6 h、24 h、48 h的WBC数、IL-6、IL-8、TNF-α浓度。结果 WBC数过滤组CPB余血回输后1 h、6 h没有上升,低于同时点的对照组(P<0.05),回输后24 h与对照组基本相同;IL-6、IL-8、TNF-α浓度过滤组在CPB余血过滤回输后1 h、6 h、24 h低于回输前,并且低于同时点的对照组(P<0.05),回输后48 h与对照组无明显差别(P>0.05)。结论 CPB后余血回输使用WBC滤器滤过能减少白细胞的数量,能有效抑制IL-6、IL-8、TNF-α浓度升高,减轻CPB后WBC介导的炎症反应。OBJECTIVE To study the influence of reinfusion of the remaining blood filtered by leukocyte filter after CPB on the number of WBC and the level of interleukin-6（IL-6）,interleukin-8（IL-8）,tumor necrosis factor α（TNF-α） in patients suffering rheumatic heart disease.METHODS 40 patients undergoing elective valve replacement were randomly divided into 2 groups according to the different treatment of the remaining blood,Group filer（n=20） and group control（n=20）.The number of WBC and the concentration of IL-6,IL-8,TNF-α were detected respectively at the following time points： before reinfusion of remaining blood;1h,6h,24h and 48h after reinfusion of remaining blood.RESULTS No significant change of the number of WBC was found in group filter after reinfusion at the point of 1h and 6h.The number of WBC in group filter was lower than that of in group control at the same time point（P〈0.05）,and there were no significant different in the both two groups at the point of 24h.In group filter,the concentration of IL-6,IL-8,TNF-α before reinfusion were lower than that of after reinfusion at the point of 1h,6h,24h,and lower than that of in group control at the same time point（P〈0.05）,no significant different was found in the both groups at the point of 48h（P〉0.05）.CONCLUSION Application of leukocyte filter can effectively reduce the number of WBC,can effectively inhibit the production of IL-6,IL-8,TNF-α.Therefore,application of leukocyte filter can prevent or reduce inflammatory response induced by WBC after CPB.

关 键 词：白细胞滤器 体外循环 细胞因子 全身炎症反应 

分 类 号：R654.1[医药卫生—外科学]