1,6-二磷酸果糖对体外循环期间中性粒细胞的影响  

Influence of fructose 1,6-diphosphate on polymorphonuclear neutrophils during cardiopulmonary bypass

作　　者：罗勇[1] 李世忠[2] 申树先[2] 金士翱[2] 

机构地区：[1]广东省南海市人民医院麻醉科,528200 [2]武汉同济医科大学同济医院麻醉科,430030

出　　处：《临床麻醉学杂志》2001年第8期419-421,共3页Journal of Clinical Anesthesiology

摘　　要：目的　研究体外循环下 1,6 二磷酸果糖 (FDP)对中性粒细胞 (PMNs)活化、释放的影响。方法　 2 0例先心病矫正术患者随机分成使用FDP( 2 2 0mg/kg)的观察组 (n =10 )和对照组 (n =10 ) ,动态观察中性粒细胞化学发光 (PMN CL)值、中性粒细胞内髓过氧化物酶 (MPO)及弹性蛋白酶(ELA)活性。结果　 ( 1)与阻断主动脉时对比 ,两组各时点PMN CL值均明显升高 (P <0 0 5、P <0 0 1或P <0 0 0 1) ,PMN MPO及ELA活性降低 (P <0 0 5或P <0 0 1) ,化学发光最高值、MPO及ELA活性最低值出现在主动脉开放后 (再灌注 ) 4 5分钟。 ( 2 )与对照组相比 ,在主动脉阻断 3 0分钟、主动脉开放后 (再灌注 ) 4 5分钟及 90分钟 ,观察组PMN CL值降低 ,PMN MPO及ELA活性升高 (P<0 0 5或P <0 0 1)。结论　 ( 1)体外循环时PMNs活化并释放多种活性物质 ,且主要发生于主动脉开放后 (再灌注 )早期。 ( 2 )FDP抑制PMNs的活化 ,减轻了PMNs的释放反应。Objective To investigate the effect of fructose 1,6 diphosphate (FDP) on the activity and release of polymorphonuclear neutrophils(PMNs) during cardiopulmonary bypass(CPB).Methods Twenty patients with congenital heart disease scheduled for cardiac surgery were randonly divided into two groups.In test group( n= 10),the patients received 220mg/kg of FDP through the aorta during CPB and in control group( n= 10),the equal volume of cardioplegia without FDP were given during CPB.After completing the procedures,at 0 min and 30min after the aorta clamped,at 45 and 90min after the aorta clamp released,the arterial blood samples were taken for the measurements of chemiluminescence(CL),myeloperoxidase(MPO)and andelastase (ELA) of PMNs.Results (1)Comparing with 0min PMN MPO and PMN ELA decreased and PMN CL increased significantly ( P< 0 05 or P< 0 01).The peak reaction was showed at 45min after the clamp realeased in both groups.(2)In contrast with control group,PMN CL lowed,PMN MPO and ELA increased in FDP growp( P< 0 05 or P< 0 01).Conclusions (1)PMNs activated and released various activator during CPB,which happened mainly during early period of reperfusion.(2)FDP could inhibit activ ation of PMNs and deerease the release.

关 键 词：心肺转流 1 6-二磷酸果糖 中性粒细胞 体外循环期间 心脏病 手术 麻醉药 

分 类 号：R654.1[医药卫生—外科学] R971.2[医药卫生—临床医学]