抑肽酶对心瓣膜置换术患者围术期IL-6、IL-8释放的影响  

Effect of Aprotinin on IL-6 and IL-8 in the Serum of Patients with Cardiac Valve Replacement During Perioperative Period

作　　者：张平[1] 肖锡俊[2] 殷得福[2] 庄翔[2] 罗朝志[3] 陈永祥[2] 黄旭中[2] 田子朴[2] 

机构地区：[1]华西医科大学免疫教研室,,成都610041 [2]华西医科大学附属第一医院胸心外科 [3]华西医科大学麻醉科

出　　处：《中国胸心血管外科临床杂志》2001年第2期95-97,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省科委资助课题!(98-G0 12 8)&&

摘　　要：目的　了解抑肽酶对心瓣膜置换术患者围术期全身炎症应答的影响。　方法　将接受心瓣膜置换术的16例患者随机分为 :对照组 (n=8) ,不用抑肽酶 ;治疗组 (n=8) ,于预冲液中加入抑肽酶 30 0万单位 ,分别于术前、停机、停机后 1小时和术后 1天抽取外周血 2 ml,收集血清用酶联免疫吸附测定 (EL ISA)双抗夹心法检测白细胞介素 - 6(IL- 6 )和白细胞介素 - 8(IL- 8)。　结果　体外循环术后患者血清 IL- 6和 IL- 8水平升高 (P<0 .0 5 ) ;术后 1天仍高于术前 ;停机后 1小时治疗组 IL - 6水平和停机时 IL - 8水平低于对照组 ,但差别均无显著性意义 (P>0 .0 5 )。　结论　尽管抑肽酶有抗炎症效应 ,但仅预冲液中加入抑肽酶 30 0万单位无法有效抑制心瓣膜置换术患者围术期促炎性细胞因子IL - 6和 IL -Objective To explore the effect of Aprotintin on whole-body inflammatory response in the patients with cardiac valve replacement during perioperative period. Methods Sixteen patients undergoing cardiac valve replacement were randomized to control group (n=8) which received an equivalent volume prime without aprotinin and the aprotinin therapy group (n=8) which received 3×106 IU of aprotinin added to the priming solution of the extracorporeal circulation (ECC). Serum samples were collected before the operation, at the end of ECC, 1 h after the end of ECC and 1 d after the operation respectively. interleukin-6(IL-6) and interleukin-8(IL-8) were assayed by enzyme-linked immunoadsorbent techniques. Results After ECC the levels of IL-6 and IL-8 increased significantly in both groups (P<0.05). The levels of 1d after the operation were still higher than that before the operation in both groups, but there were no statistic significance (P>0.05). At 1h after the end of ECC, the level of IL-6 in aprotinin group was lower than that of control group (P>0.05). At the end of ECC, the level of IL-8 in aprotinin group was lower than that of control group (P>0.05)。 Conclusion Although aprotinin has antiinflammatory activity, but pump prime adding aprotinin 3×106 IU only may fail to attenuate proinflammatory cytokine release (IL-6,IL-8) effectively in patients with cardiac valve replacement during perioperative period.

关 键 词：抑肽酶 心瓣膜置换术 促炎症细胞子 围手术期 

分 类 号：R654.2[医药卫生—外科学] R392.12[医药卫生—临床医学]