盐酸戊乙奎醚对心肺转流患者肠损伤和炎性因子的影响  

Effect of penehyclidine hydrochloride on gut injury and cytokines during cardiopulmonary bypass in patients undergoing open heart surgery

作　　者：张丽丽[1,2] 孙莹杰[1] 张铁铮[1] 

机构地区：[1]沈阳军区总医院麻醉科,110016 [2]松原市同心医院麻醉科

出　　处：《临床麻醉学杂志》2011年第4期328-330,共3页Journal of Clinical Anesthesiology

基　　金：辽宁省博士启动基金(20091099)

摘　　要：目的探讨盐酸戊乙奎醚对心肺转流（CPB）患者肠损伤和炎性因子的影响。方法40例ASAⅡ或Ⅲ级心瓣膜置换术患者，随机均分为盐酸戊乙奎醚组（P组）和对照组（C组），分别在CPB前10min颈内静脉注射盐酸戊乙奎醚0．05mg／kg或等容量生理盐水。分别于CPB前（T1）、主动脉开放10min（T2）、停CPB即刻（T3）、术后2h（T4）、6h（T5）、18h（T6）采取中心静脉血，应用ELISA法检测血清肠型脂肪酸结合蛋白（I-FABP）、白细胞介素-6（IL-6）、自细胞介素-10（IL10）浓度。结果与T1时比较，T2～T6时两组I-FABP、IL-6和IL-10浓度均显著升高（P〈0．05）。T2、T4、T5时P组I-FABP浓度显著低于C组，T4、T5时IL-6浓度亦显著低于C组（P〈0．05）。结论盐酸戊乙奎醚0．05mg／kg可减轻患者肠损伤和炎性因子的释放。Objective To observe the effect of penehyclidine hydrochloride on gut injury and cytokines during cardiopulmonary bypass in patients undergoing open heart surgery. Methods Forty patients undergoing heart valve replacement with cardiopulmonary bypass were randomly divided into two groups with 20 cases each： penehyclidine group （group P）and control group （group C） respectively. Patients in group P were injected PHC 0. 05 mg/kg before CPB 10 mins from the internal jugular vein, patients in group C were injected the same volume saline. Jugular vein blood was drawn at the following 6 time points： before CPB （T1）, 10 rain after aortic crossclamp release （T2）, immediately at the end of CPB （T3）, 2 h after operation（T4 ）, 6 h after operation（T5 ）, 18 h after operation（T6 ）. The density of blood I-FABP was detected by enzyme-linked immunosorbent assay as well as cytokine levels （IL-6, IU-10）. Results Comparing with T1 （beforeCPB）, the concentration of blood I-FABP, IL-6 and IL-10 all increased significantly at T2, T3, T4, Ts, T6 （P〈 0. 05）. In group P, the concentration of blood I-FABP was significantly lower at T2, T4, T6 than those in group C（P〈0. 05）. In group P, the concentration of IL-6 was significantly lower at T4. T6 than those in group C （P〈0. 05）. Conclusion 0. 05 mg/kg penehyclidine hydrochloride preconditioning before CPB could reduce blood level of IL-6 and has gut protection effect.

关 键 词：盐酸戊乙奎醚 心肺转流 肠损伤 血清肠型脂肪酸结合蛋白 细胞活素类 

分 类 号：R614[医药卫生—麻醉学]