洗涤库血对婴幼儿体外循环术后炎症因子表达及乳酸水平的影响  

Effect of processing banked suspended red blood cells on the expression of inflammatory factors and the level of lactic acid after cardiopulmonary bypass in infants

作　　者：朱全伟 刘宇航 卢绪宁 文平 ZHU Quan-wei;LIU Yu-hang;LU Xu-ning;WEN Ping(Cardiac Center,Dalian Children′s Hospital of Dalian Medical University,Liaoning Province,Dalian 116012,China)

机构地区：[1]大连医科大学附属大连市儿童医院心脏中心,辽宁大连116012

出　　处：《中国当代医药》2021年第6期17-20,共4页China Modern Medicine

摘　　要：目的探讨洗涤库血对婴幼儿体外循环术后炎症因子表达及乳酸(Lac)水平的影响。方法选取2018年6月~2019年12月大连医科大学附属大连市儿童医院收治的40例行体外循环下单纯室间隔缺损修补手术患儿作为研究对象,按照入院先后顺序的方法进行分组,其中单号为洗涤组(A组,20例),双号为对照组(B组,20例)。A组应用血液回收机对库存悬浮红细胞进行洗涤处理后再预充,B组用库存悬浮红细胞直接预充。分别在体外循环开始前(T1)、体外循环结束时(T2)、术后6 h(T3)、术后24 h(T4)取动脉血行肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-10(IL-10)和Lac检测,比较两组的结果差异。结果两组患儿T1时各项炎症因子指标及Lac水平比较,差异无统计学意义(P>0.05);A组患儿T2、T3、T4时TNF-α、IL-6、IL-10水平均低于B组,差异有统计学意义(P<0.05);A组患儿T2时Lac水平低于B组,差异有统计学意义(P<0.05)。两组患儿的转流资料比较,差异无统计学意义(P>0.05)。结论洗涤库血应用于婴幼儿的体外循环手术,可减少外源性杂质及Lac的输入,显著降低婴幼儿体外循环术后机体炎症因子表达及Lac水平,减轻全身炎症反应,利于患儿术后恢复。Objective To investigate the effect of processing banked suspended red blood cells on the expression of inflammatory factors and the level of lactic acid(Lac)after cardiopulmonary bypass in infants.Methods A total of 40 children who underwent simple ventricular septal defect repair surgery under cardiopulmonary bypass admitted to Dalian Children′s Hospital of Dalian Medical University from June 2018 to December 2019 were selected as the research subjects.According to the order of admission,the odd number was classified into the processing group(group A,n=20),the even number was classified into the control group(group B,n=20).In group A,processing banked suspended red blood cells with cell saver before priming was used,while in group B,banked suspended red blood cells was directly processed.Arterial blood samples were collected before the initiation of cardiopulmonary bypass(T1),end of cardiopulmonary bypass(T2),6 h after surgery(T3),and 24 h after surgery(T4)for tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10)and Lac tests.The differences in the results of the two groups were compared.Results There were no statistically significant differences in the inflammatory factors and Lac levels at T1 between the two groups(P>0.05).The levels of TNF-α,IL-6 and IL-10 at T2,T3 and T4 in group A were lower than those in group B,and the differences were statistically significant(P<0.05).The level of Lac in group A was lower than in group B at T2,and the difference was statistically significant(P<0.05).There was no significant difference in the diversion data between the two groups(P>0.05).Conclusion The application of processing banked suspended red blood cells to infants′cardiopulmonary bypass surgery can reduce the input of exogenous impurities and Lac,significantly decrease the expression of inflammatory factors and the level of Lac after cardiopulmonary bypass in infants,and ameliorate the systemic inflammatory response,which is beneficial to the recovery of infants after surgery.

关 键 词：红细胞 体外循环 炎症因子 婴幼儿 

分 类 号：R722[医药卫生—儿科]