胸腺五肽对体外循环患者围术期细胞免疫功能及细胞因子的影响  

Effect of perioperative administration of Thymopentin on cellular immunity and cytokine level following cardiopulmonary bypass

作　　者：殷胜利[1] 柳发铿[1] 蔡冬梅[1] 张希[1] 

机构地区：[1]中山大学附属第一医院心外科,广州510080

出　　处：《心肺血管病杂志》2011年第2期116-118,121,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨胸腺五肽对体外循环患者围术期细胞免疫功能及细胞因子的影响。方法:将26例体外循环瓣膜置换术的成年患者,随机分为胸腺五肽组14例(T组)和对照组12例(C组)。胸腺五肽组术前第1天至术后第7天予胸腺五肽10 mg肌注,1次/d,对照组作空白处理。观察术前1 d、体外循环停机时以及术后第1,3,7及11 d外周血CD4+/CD8+血浆白介素10(IL-10)和肿瘤坏死因子α(TNF-α)的水平及血细胞计数等。结果:2组术后中性粒细胞先升后降,术后胸腺五肽组中性粒细胞计数于第7天及第11天较对照组均明显升高(P<0.05);2组术后CD4+/CD8+先降后升,胸腺五肽组回升较对照组早且快;2组体外循环停机时TNF-α较术前均明显上升,术后第1天和第3天胸腺五肽组TNF-α均明显低于对照组(P<0.05)。结论:胸腺五肽对体外循环术后的细胞免疫功能低下有治疗作用,同时可以缓解全身炎性反应。Objective：To investigate the effect of perioperative administration of thymopentin on cellular im-munity and cytokine level following cardiopulmonary bypass.Methods：26 patients requiring valve replacement were randomly divided into thymopentin group（T group,n=14） and Control group（C group,n=12）.In thymopentin group,thymopentin was injected intramuscularly,10mg/d from the day before operation to the 7th day after opera-tion.Blank injection was committed in contrast group.CD4＋/CD8＋,serum IL-10 level,serum TNF-α level,WBC count,neutrophilia count and lymphocyte count were observed in both group respectively at the day before operation,the end of cardiopulmonary bypass,the 1st,3rd,7th and 11th day after operation.Results：In both groups,peripheral neutrophilial cell declined abruptly at the end of cardiopulmonary bypass compared to that before operation,and in-creased after operation.The thymopentin group had a faster recovery of peripheral neutrophilial cell level,and the peripheral neutrophilial cell of the 7th and 11th day after operation were significantly higher than the contrast group.In both groups,the CD4＋/CD8＋ ratio is declined at the end of cardiopulmonary bypass compared to that before operation（P〈0.05）,and then increased after operation.In the thymopentin group,CD4 ＋/CD8＋ ratio at the 1st,3^rdand 7^th day after operation were significantly higher than the contrast group.In both groups,serum TNF-α were significantly elevated at the end of cardiopulmonary bypass,and decreased gradually after operation.In the thymopentin group,TNF-α decreased faster,and TNF-α level at the 1st and 3rdday after operation were significantly lower than the contrast group.Conclusion：Perioperative administration of thymopentin can improve cellular immunity and relief systemic inflammatory response following cardiopulmonary bypass.

关 键 词：胸腺五肽 体外循环 心瓣膜病 细胞免疫 细胞因子 

分 类 号：R542.5[医药卫生—心血管疾病]