体外循环手术后血浆PAF、IL-8、IFN-γ的变化与急性肺损伤/急性呼吸窘迫综合征的相关性研究  

Study on the correlation between changes in plasma levels of PAF,IL-8 and IFN-γ and the status of disease in patients with acute lung injury / acute respiratory distress syndrome after cardiopulmonary bypass surgery

作　　者：赵林林[1] 姜珊 王洋[1] 李春晖[1] 李强[1] 

机构地区：[1]辽宁省人民医院心外科,辽宁沈阳110016 [2]盛京医院滑翔分院呼吸科,辽宁沈阳110022

出　　处：《临床和实验医学杂志》2015年第4期304-306,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的体外循环手术后测定血浆血小板激活因子(PAF)、白细胞介素-8(IL-8)、γ-干扰素(IFN-γ)水平变化,分析血浆PAF、IL-8、IFN-γ水平与急性肺损伤/急性呼吸窘迫综合征关系。方法选择2006年12月份至2014年6月份应用体外循环手术治疗的156例患者作为观察对象,其中67例并发急性肺损伤/急性呼吸窘迫综合征,即观察组,另89例未发生急性肺损伤/急性呼吸窘迫综合征作为对照组。在术前、术后1 d、3 d及7 d采用酶联免疫吸附测定法检测血浆中PAF、IL-8及IFN-γ浓度,并对结果进行统计学分析。结果观察组患者手术后血浆PAF、IL-8和IFN-γ浓度明显高于手术前(P<0.05);对照组患者手术前后各时段血浆PAF、IL-8和IFN-γ无明显波动(P>0.05);观察组血浆PAF、IL-8和IFN-γ浓度明显升高并在术后3 d时达最高值后逐渐下降,但术后各时间的浓度值均显著高于手术前(P<0.05);手术后同一时间点相比较,观察组血浆PAF、IL-8和IFN-γ水平显著高于对照组(P<0.05)。结论体外循环手术后ALI/ARDS患者血浆PAF、IL-8和IFN-γ变化显著,血浆PAF、IL-8和IFN-γ变化与ALI/ARDS发生关系密切。Objective To detect the plasma levels of PAF（ platelet activating factor）,IL-8（ interleukin-8） and IFN-γ（ gamma-interferon） in patients after cardiopulmonary bypass surgery,and to analyze the correlation between changes in plasma levels of PAF,IL-8 and IFN-γ and the status of disease in patients with acute lung injury / acute respiratory distress syndrome.Methods A total of 156 patients treated with cardiopulmonary bypass surgery during December 2006 to June 2014 were selected for this study,among them,67 cases with acute lung injury and acute respiratory distress syndrome were allocated in observation group,and 89 cases without acute lung injury and acute respiratory distress syndrome were allocated in control group.The plasma levels of PAF,IL-8 and IFN-γ were examined by using ELISA before surgery,1 d,3 d and 7 d after the surgery,and their results were statistically analyzed.Results The plasma levels of PAF,IL-8 and IFN-γ in patients after surgery were significantly higher than those before surgery（ P0.05）.There was no significant fluctuations in plasma levels of PAF,IL-8 and IFN-γ in patients of control group before and after surgery（ P0.05）.The plasma levels of PAF,IL-8 and IFN-γ in patients of observation group were markedly elevated and reached the highest point in postoperative 3d and then they were gradually decreased,but their values after surgery were significantly higher than those before the surgery（ P0.05）.At the same time point after surgery,the plasma levels of PAF,IL-8and IFN-γ in observation group were significant higher than those in control group（ P0.05）.Conclusion The changes in plasma levels of PAF,IL-8 and IFN-γ were significant in patients with ALI / ARDS after cardiopulmonary bypass surgery.There is close correlation between the changes in plasma levels of PAF,IL-8,IFN-γ and the occurrence of ALI / ARDS.

关 键 词：急性肺损伤/急性呼吸窘迫综合征 体外循环手术 血小板激活因子 白细胞介素8 γ-干扰素 

分 类 号：R563.8[医药卫生—呼吸系统]