风湿性心脏病二尖瓣置换术中细胞因子水平的变化  

Changes of Plasma Cytokines in Mitral Valve Replacement for Rheumatic Heart Disease

作　　者：郭继革[1] 何正富[1] 陈自立[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院心胸外科,浙江杭州310016

出　　处：《中国体外循环杂志》2003年第4期213-215,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的测定风湿性心脏病二尖瓣置换术中细胞因子水平,了解它们的变化规律。方法 11例体外循环(CPB)下二尖瓣置换术患者,分别于术前,主动脉阻断前,主动脉阻断后5min,主动脉开放后10min、1h、2h、4h、24h测定白介素6(IL-6)、白介素8(IL-8)、白介素10(IL-10)以及肿瘤坏死因子(TNF)。结果IL-6、IL-8、IL-10水平在CPB开始后逐渐升高,在主动脉开放后2h左右达到高峰(P<0.01)。之后逐渐下降,到主动脉开放后24h已显著下降。TNF水平在CPB开始后逐渐升高,在主动脉开放后24h仍维持在很高的水平(P<0.01)。结论CPB下二尖瓣置换术中既有促炎因子水平的升高,又有抗炎因子的激活。OBJECTIVE To investigate the changes of plasma cytokines in patients undergoing mitral valve replacement for rheumatic heart disease. METHODS 11 patients undergoing mitral valve replacement(MVR) under cardiopul-monary bypass(CPB). We measure the plasma levels of IL -6,IL-8,IL - 10 and TNF by ELISA method. Serial venous blood samples were collected at the following intervals respectively; Pre - op, Before -aorta clamping, 5min after aortic cross - clamping and 1h,2h,4h,24h after aorta declamping. RESULTS The plasma levels of IL - 6, IL - 8 , IL - 10 and TNF gradually increased after the beginning of CPB. And IL - 6, IL - 8, IL - 10 reached the peak at 2h after aorta declamping( P <0. 01). TNF still maintains a high level at 24h after aorta declamping( P <0. 01) . CONCLUSION our study demonstrated that there were increases of plasma pro - inflammatory cytokines , but also elevation of plasma anti - inflammatory cytokine during mitral valve replacement under CPB.

关 键 词：风湿性心脏病 二尖瓣置换术 细胞因子 白细胞介素-6 白细胞介素-8 白细胞介素-10 肿瘤坏死因子 体外循环 

分 类 号：R654.2[医药卫生—外科学]