前列地尔脂肪乳剂在体外循环冠状动脉旁路移植术中对炎症反应的作用  

Effect of Liposomal Prostaglandin E1 on Inflammatory Reaction During Cardiopulmonary Bypass Coronary Artery Bypass Grafting

作　　者：李卫国[1] 谷天祥[2] 申莲玉[1] 吴兵[1] 李荣[1] 王朝晖[1] 张宏[1] 

机构地区：[1]锦州市中心医院心血管外科,辽宁锦州121000 [2]中国医科大学附属第一医院心脏外科,沈阳110001

出　　处：《中国胸心血管外科临床杂志》2011年第6期510-513,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨前列地尔脂肪乳剂(liposomal prostaglandin E1,Lipo-PGE1)在体外循环(CPB)冠状动脉旁路移植术(CABG)中对炎症反应的作用。方法选取2006年7月至2008年12月锦州市中心医院32例冠心病需行CABG治疗患者,按随机数字表法分为两组,每组16例。实验组:男9例,女7例;年龄54.4±18.1岁;CPB开始前至CPB结束持续经中心静脉泵入Lipo-PGE1[15.0ng/(kg.min)];对照组:男9例,女7例;年龄54.8±20.4岁;除不使用Lipo-PGE1外,其他操作均与实验组相同。分别于CPB前,升主动脉开放后1h、2h、6h和24h抽取两组患者的动脉血,检测血浆白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)及可溶性细胞间黏附分子1(sICAM-1)的浓度,并对两组检测结果进行比较。结果升主动脉开放后两组血浆IL-6、TNF-α和sICAM-1浓度均逐渐升高,后两者于升主动脉开放后6h达峰值。实验组升主动脉开放后各时间点血浆IL-6(升主动脉开放后24h:16.1±2.2μg/L vs.19.2±4.5μg/L,P<0.05)、TNF-α(升主动脉开放后24h:1.8±0.4μg/L vs.2.2±0.5μg/L,P<0.05)和sICAM-1(升主动脉开放后24h:233.6±36.6μg/L vs.294.2±55.7μg/L,P<0.05)浓度均较对照组明显降低。结论 Lipo-PGE1可减轻CPB引起的中性粒细胞聚集,抑制血管内皮细胞的激活,减轻血管内皮细胞损伤和全身炎症反应。Abstract： Objective To investigate the effect of liposomal prostaglandin Elt （Lipo-PGE） on inflammatory reaction during cardiopulmonary bypass （CPB） coronary artery bypass grafting （CABG）. Methods Between July 2006 and December 2008, a total of 32 patients undergoing （2ABG were randomly divided into two groups of 16 patients each using a random digits table. The experimental group had 9 male and 7 female patients with a mean age of 54.4 ± 18. 1 years; each patient received 15. 0 ng/（kg . rain） of Lipo-PGEl by venous pump through the central vein throughout the CPB procedure. The control group had 9 male and 7 female patients with a mean age of 54.8±20.4 years, who were treated identically to the experimental group except did not receive l.ipo-PGE. Arterial blood samples were taken before CPB and at the 1st, 2nd, 6th, and 24th hour after open aorta ascendens. The levels of interleukin-6 （IL-6）, tumor necrosis factor-a （TNF-cD, and soluble intercellular adhesion molecule-1 （slCAM-I） were tested and compared. Results In both groups, levels of IL-6, TNF-a, and slCAM-1 were all gradually increased after the ascending aorta was opened, and they reached their highest levels at the 6th hour after open aorta ascendens. In the experimental group, at every time point after the ascending aorta was open, levels of Ig 6 （24th hour after open aorta ascendens： 16.1±2.2 μg/Lvs. 19.2±4.5 μg/L,P〈0.05）, TNF-a （24thhour after open aortaascendens： 1.8±0.4 μg/L vs. 2.2±0.5 μg/L,P〈0.05）, and sICAM-1 （24th hour after open aorta ascendens： 233.64±36.6 μg/L vs. 294.2± 55. 7 μg/L, P%0. 05） were significantly lower than those of the control group. Conclusion effectively reduces the aggregation of polymorphonuclear neutrophilic leukocytes, inhibits endothelial cells, and decreases systemic inflammatorome during CPB. I.ipo-PGE of vascular

关 键 词：前列地尔脂肪乳剂 炎症反应 体外循环 冠状动脉旁路移植术 

分 类 号：R654.1[医药卫生—外科学]