依达拉奉在心脏不停跳手术中的肺保护作用  

Pulmonary protection of edaravone in patients undergoing on-pump beating heart surgery

作　　者：刘俊[1] 冼磊[1] 何巍[1] 郭建极[1] 蔡志福[1] 

机构地区：[1]广西医科大学第一附属医院,南宁530021

出　　处：《山东医药》2010年第28期54-56,共3页Shandong Medical Journal

基　　金：广西省医疗卫生重点科研课题(桂卫重200922)

摘　　要：目的探讨依达拉奉在心脏不停跳手术中对肺功能的保护作用。方法将60例需行二尖瓣置换术的风湿性心脏病患者随机分成实验组、对照组各30例。实验组于预充液中按0.5 mg/kg加入依达拉奉,对照组加入等量生理盐水。分别于术前、转机30 min、停机、术毕、术后24 h、术后72 h各时点检测血浆IL-6、IL-8含量,并于术前、停机、停机后1 h、术毕记录气道峰压、潮气量,并行动脉血气分析,计算动态肺顺应性、肺泡—动脉血氧分压差、氧合指数。结果两组IL-6、IL-8浓度水平均随体外循环及手术时间逐渐增高,于手术结束时达高峰,术后24 h下降,实验组IL-6、IL-8低于对照组(P<0.01)。两组气道峰压、肺泡—动脉血氧分压差自手术开始后升高,动态肺顺应性、氧合指数自手术开始后下降,依达拉奉组结果优于对照组(P<0.01)。结论依达拉奉可清除体内过量生成的氧自由基及减少炎性因子的生成,减轻全身炎性反应及肺组织损伤,具有减轻体外循环急性肺损伤的作用。Objective To investigate the effect of edaravone on pulmonary protection in patients undergoing on-pump beating heart surgery.Methods Sixty patients with rheumatic heart disease undergoing mitral valve replacement were divided into two groups.Patients in experimental group received edaravone injection 0.5 mg/kg in circuit priming fluids whereas patients in control group received equal volume of normal saline.IL-6 and IL-8 were respectively measured at six different time intervals including preoperation,30 minutes after cardiopulmonary bypass（CPB）,termination of CPB,postoperation,24 hours after operation and 72 hours after operation.Peak airway pressure and tidal volume were recorded and arterial blood gas was analyzed at preoperation,termination of CPB,1 hour after termination of CPB and postoperation.The dynamic lung compliance,alveolar-arterial oxygen difference and oxygenation index were calculated.Results The levels of plasma cytokines in both groups were elevated from the beginning of CPB,reached peak at postoperation and declined from the time of 24 hours after operation.The level of IL-6 and IL-8 in experimental group was lower than that in control group（P〈0.01）.Peak airway pressure and alveolar-arterial oxygen difference were elevated from the beginning of operation,and yet dynamic lung compliance,oxygenation index were declined.There was a significant difference between experimental group and control group（P〈0.01）.Conclusion Edaravone can scavenging the excessive reactive oxygen species,reduce inflammatory factors in vivo,degrade the degree of systemic inflammatory response syndrome,soften the injury to lung tissue and have the ability to protect lung function.

关 键 词：依达拉奉 体外循环 肺保护 自由基 

分 类 号：R654.1[医药卫生—外科学]