乌司他丁对术中自体血回输患者血浆TNF-α、IL-6、IL-8的影响  

The effect of ulinastatin on TNF-α、IL-6、IL-8 in patients during Intraoperative blood salvage

作　　者：屈献锋[1] 钟桥生[1] 李欠玉 张琛[1] 杨小平[1] 

机构地区：[1]浙江省台州市立医院麻醉科,台州318000

出　　处：《海峡药学》2011年第8期102-104,共3页Strait Pharmaceutical Journal

摘　　要：目的观察乌司他丁对术中自体血回输患者血浆TNF-α、IL-6、IL-8水平的影响。方法术中自体血回输患者30例,男性16例,女性14例,年龄25~63岁,ASAⅠ~Ⅲ级,体重指数20~24kg/m2,随机分为两组（n=15）：乌司他丁组（U组）,于麻醉后、手术开始前将乌司他丁（Ulinastatin）20万U溶于20mL0.9%生理盐水,5min内缓慢静注,术中进行自体血回输;对照组（C组）,给予等容量生理盐水术中进行自体血回输。两组患者分别于麻醉前（T1）、术毕清醒拔除气管导管时（T2）、术后12h（T3）3个时点采集静脉血,检测血浆中肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、白介素-8（IL-8）的水平。结果两组T1时点血浆TNF-α、IL-6、IL-8的水平差异均无统计学意义（P〉0.05）;T2、T3时点血浆TNF-α、IL-6、IL-8的水平均高于T1时点（P〈0.05）。与C组比较,T2、T3时点U组血浆TNF-α、IL-6、IL-8的水平均明显降低（P〈0.05）。结论术中自体血回输可导致患者血浆TNF-α、IL-6、IL-8的水平增加,而乌司他丁可有效降低血浆TNF-α、IL-6、IL-8的水平,减轻机体炎性反应程度,从而达到对术中自体血回输患者有效地保护作用。OBJECTIVE To investigate the effect of ulinastatin on TNF-α、IL-6、IL-8 in patients during Intraoperative blood salvage（IBS）.METHODS Thirty patients of both sexes（16males,14females） aged 25~63years undergoing surgery（hip replacement、spine fracture、liver、spleen、ruptured ectopic pregnancy） duringwhich Cell Saver@5-2005 cell saver was used to salvage shed blood were randomly assigned into two groups：ulinastatin group（group U,n=15） and control group（group C,n=15）.All patients were performed general anesthesia and BP、HR、CVP、ECG and SpO2 were monitored.In group U,Ulinastatin（200,000IU） was given intravenously before anesthesia.In group C,patients only received equal volume of normal saline instead of ulinastatin.Blood samples were taken from vein before before anesthesia（T1）、at the end of surgery（T2）、postoperative 12 hours（T3）.The plasma levels of tumor nocrosis factor-alpha（TNF-α）、interleukin-6（IL-6） and interleukin-8（IL-8）were measured.RESULTS No significant difference was found in the levels of TNF-α、IL-6、IL-8 between group U and group C at T1;The levels of TNF-α、IL-6、IL-8 significantly increased in both groups at T2 and T3 compared with those at T1（P0.05）.The levels of TNF-α、IL-6、IL-8 in group U were lower than those in group C at T2 and T3（P0.05）.CONCLUSION The levels of TNF-α、IL-6、IL-8 significantly increased during IBS,Ulinastatin is effective in reducing IBS-induced inflammatory response.

关 键 词：乌司他丁 自体血回输 白介素 肿瘤坏死因子 

分 类 号：R969.4[医药卫生—药理学]