体外循环中西维来司钠对犬心肌缺血再灌注损伤的影响  

Effects of sivelestat sodium on canine myocardial ischemia/reperfusion injury during cardiopulmonary bypass

作　　者：尉迟海琴 李昌熙 方华[3] 

机构地区：[1]江苏省泰兴市第二人民医院麻醉科,江苏泰兴225411 [2]江苏省扬州市苏北人民医院疼痛科,江苏扬州225001 [3]贵州省人民医院麻醉科,贵州贵阳550002

出　　处：《实用临床医药杂志》2013年第9期5-8,共4页Journal of Clinical Medicine in Practice

基　　金：贵阳市科学技术计划项目([2010]筑科农合同字第1-社-33号);贵州省科技厅基金(黔科合LY字[2011]008号);贵州省科技厅基金(黔科合SY字[2012]3090号)

摘　　要：目的探讨中性粒细胞弹性蛋白酶(NE)抑制剂西维来司钠对犬体外循环(CPB)中促炎性细胞因子IL-8和IL-1β引起的心肌缺血再灌注损伤的保护效果。方法将12只犬随机分为C组(n=6)和S组(n=6),建立CPB心肌缺血再灌注损伤模型。S组于CPB前静脉注射西维来司钠40 mg/kg,C组静脉注射等量生理盐水。分别于CPB前及转机后不同时点采集静脉血,检测炎性因子的浓度;于阻断前后分别取心肌标本进行丙二醛(MDA)和髓过氧化物酶(MPO)活性检测;于阻断前,开放30、60min测定血流动力学指标。结果阻断60min后,2组NE、IL-8和IL-1β浓度均显著升高(P<0.01);阻断60min及开放主动脉后,S组中性粒细胞数、NE、IL-8和IL-1β浓度显著低于C组(P<0.01);与C组比较,S组阻断60 min及开放主动脉60min时心肌组织匀浆MDA和MPO均显著降低(P<0.01),S组在开放主动脉30、60min时血流动力学指标恢复迅速(P<0.01)。结论 CPB中应用西维来司钠可明显减轻促炎性细胞因子和中性粒细胞介导的心肌缺血再灌注损伤。Objective To elucidate the protective effect of neutrophil elastase（NE）inhibitor-sivelestat sodium on the pro-inflammatory cytokines（IL-8 and IL-1β）-mediated myocardial ischemia-reperfusion injury during cardiopulmonary bypass（CPB）.Methods Twelve adult healthy dogs undergoing CPB were randomized into control group（group C,n=6） and sivelestat sodium group（group S,n=6）.In group S,sivelestat sodium 40 mg/kg was administered intravenously before CPB.Group C was treated with as group S but administering physiological saline as a substitute for sivelestat sodium.Before CPB,and after turnaround,venous blood was collected to detect the concentration of inflammatory factors.Cardiac tissues samples were taken for determination of the levels of malondialdehyde（MDA） and the myeloperoxidase（MPO） activity before CPB and after CBP.Hemodynamic parameters were measured before CPB,30 min after AC and 60 min after DC.Results The neutrophilaccount,NE,IL-8 and IL-1β concentrations increased significantly after DC in two groups but were noticeably lower in group S than those in group C（P0.01）.MDA levels and MPO activity at 60 min after AC and 60 min after DC were distinctly lower in group S than those in group C（P0.01）.Hemodynamics of group S were quickly recovered at 30 min and 60 min after DC than those in group C（P0.01）.Conclusion Pro-inflammatory cytokine（IL-8 and IL-1β）and neutrophil might participate in inflammation-mediated myocardial ischemia-reperfusion injury which could be distinctly attenuated by sivelestat sodium.

关 键 词：西维来司钠 心肌保护 体外循环 缺血再灌注损伤 

分 类 号：R542.2[医药卫生—心血管疾病]