乌司他丁对体外循环术后外周血单核细胞亚群的影响  

The effect of ulinastatin on peripheral blood monocyte subsets of the patients receiving cardiopulmonary bypass

作　　者：江春景[1] 郝星[1] 韩俊燕[2] 邢智辰[1] 郝禹[2] 曾辉[2] 侯晓彤[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所体外循环科,北京100029 [2]首都医科大学附属北京地坛医院传染病学研究所

出　　处：《心肺血管病杂志》2013年第2期108-111,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金资助项目(81070203);北京市卫生系统高层次卫生技术人才(学科带头人);天普研究基金资助项目(01201016)

摘　　要：目的:通过动态监测体外循环前后单核细胞各亚群表型及数量变化,研究乌司他丁对体外循环患者免疫功能的影响。方法:收集择期行心脏瓣膜置换术患者20例,随机分成乌司他丁组(U+组)和对照组(U-组),每组10例。于麻醉后CPB前(T1)、CPB停机0h(T2)、术后1d(T3)及3d(T4)四个时间点采取外周抗凝血。采用流式细胞仪结合绝对计数法,观察乌司他丁的应用对于CPB术后患者单核细胞各亚群比例和数目,及不同单核细胞亚群表面免疫功能相关分子Toll样受体-4(toll-like recep-tor-4,TLR-4)和人白细胞抗原-DR(human leukocyte antigen DR,HLA-DR)表达动态变化的影响。结果:U-组和U+组单核细胞亚群Mo1、Mo2和Mo3数目在停机0h均有所下降;术后1d,Mo1和Mo2数量有不同程度升高;术后3d,Mo1及Mo2数目均有所下降,但U+组的细胞数目明显低于U-组(P<0.05)。结论:在CPB围术期使用乌司他丁可减少外周血单核细胞亚群数量,从而减弱CPB诱发的炎症反应。Objective：To explore the effect of ulinastatin on immune response of the patients receiving cardiopulmonary bypass（CPB） by monitoring the dynamic change of monocyte subsets absolute count and the function-related molecules.Methods：Twenty patients with heart valve replacement operations were randomly divided into two groups： ulinastatin group（U＋） and control group（U-）.The U＋ group were given ulinastatin 1,0000U/kg at the immediate of CPB,while the U-groupwere not.Collect peripheral blood samples at four points,after anesthesia and before CPB operation（T1）,CPB weaning 0h（T2）,post-operation 1 d（T3） and 3 d（T4）.The percentage and absolute count of monocyte subsets and the expression of TLR-4 and HLA-DR were detected by flow cytometry.Results：The absolute count of Mo1,Mo2 and Mo3 monocyte subsets of U＋ group and U-group were decreased at the time of CPB weaning 0 h;Mo1 and Mo2 were slowly increased at the day 1 after CPB;Mo1 and Mo2 were slowly declined at day 3 after CPB and the absolute count of Mo1 and Mo2 subsets in U＋ group were significant lower than that of U-group（P0.05）.Conclusion：The application of ulinastatin could attenuate CPB-induced inflammatory response by reducing the quantities of monocyte subsets at the CPB peri-operative period.

关 键 词：体外循环 乌司他丁 外周血单核细胞亚群 

分 类 号：R54[医药卫生—心血管疾病]