1,6-二磷酸果糖对体外循环患者血浆细胞因子的影响  

Clinic study of fructose01,60 diphosphate on plas macytokine in patients underwent cardio pulmonary bypasss

作　　者：雷印胜[1] 郭兰敏[1] 范全心[1] 

机构地区：[1]山东省立医院

出　　处：《山东医药》2004年第6期4-6,共3页Shandong Medical Journal

摘　　要：目的　探讨 1,6-二磷酸果糖 (FDP)减轻体外循环 (CPB)术后全身炎症反应的临床效果。方法　将 3 8例心脏直视手术患者随机分为实验组 2 0例 ,对照组 18例。实验组在常规 CPB预充液中加入 FDP2 0 0 m g/kg,对照组不用 FDP。于手术开始前 (T0 )、 CPB结束后即刻 (T1)、CPB结束后 3小时 (T2 )、 6小时 (T3)及 2 4小时 (T4)分别抽取桡动脉血 ,采用 EL ISA法测定血浆肿瘤坏死因子 (TNF-α)、白介素 -6(IL-6)、白介素 -8(IL-8) ,用硫代巴比妥酸比色法测定血浆丙二醛 (MDA)。结果　两组术前血浆 TNF-α、IL-6、IL-8、MDA浓度无差异 ,CPB结束后均已明显升高 (P <0 .0 5) ,CPB后 3小时 TNF-α、 IL -6、 IL -8达高峰 ,6小时开始下降 ,MDA在 6小时达高峰 ,2 4小时 TNF-α、 MDA恢复到接近术前水平 (P >0 .0 5) ,IL -6、 IL -8仍高于术前 (P <0 .0 5)。实验组血浆 TNF-α、 IL -6、 IL -8浓度在 T1、 T2 、 T3均明显低于对照组 (P <0 .0 1) ,MDA浓度在 T1、 T2 (P <0 .0 5)和 T3 (P <0 .0 1)均明显低于对照组 ,血浆 IL -6、 IL -8在 T4也均低于对照组 (P <0 .0 1,P <0 .0 5)。结论　 CPB术后血浆 TNF-α、IL-6、IL-8、MDA浓度明显升高 ,在 CPB预充液中加入 FDP可明显降低 CPB术后TNF-α、 IL-6、 IL-8及 MDA的浓度 ,Objective To investigate the e ffect of whether fructose01,60dipho sphate(FDP) alleviating the systemic infla mmato ry response induced by cardiopulmonary bypas s(CP B) Methods 38 patients sched uled fo r cardiac surgery under CPB were randomly di vided into 2 groups In treated group (n=20) ,FDP(200mg/kg)was added into th e prime before CPB,but in control group (n= 18) no FDP was used Blood sample s were drawn from the radial artery at the fo llowing time points:before CPB(T 0 ),at the end of CPB(T 1),3 hours after CPB( T 2),6 hours after CPB (T 3),24 hours after CPB(T 4) The plasma l evels of tumor necrosis fa ctor0α(TNF0а),interleukin06(IL06),interl eukin08(IL08)and malondialdehyd e(MDA) were measured Results Plasma levels of TNF0α,IL06 IL08 and MDA in t he 2 grou ps showed no difference before CPB They all rose at the end of CPB TNF0α,IL06 and IL08 pe aked at 3 hours after the CPB,MDA pe aked at 6 hours after the CPB TNF0 α,IL06,IL08 began to decline at 6 hours MDA ,TNF0α decreased to the preoperative level s at 24 hours after CPB IL06,IL08 were stil l higher than the preoperative levels (P< 0 01) Plasma levels of TNF0α,IL06,IL08 in the t reated group were significantly lower than those in the control group at T 1 ,T 2 ,T 3 (P<0 01) Plasma level of MDA in the treated g roup were significantly lower than those in the control group at T 1 ,T 2 (P<0 05),T 3 (P<0 01) levels of IL06,IL08 in the treated group were lower than thaf of the control grou p at 24 hours after CPB (P<0 01,P<0 05) Conclusion FDP can reduce th e TNF0α,IL06,IL08,MDA after CPB and allevi ate the systemic inflammatory response indu ced by cardiopulmonary bypasss

关 键 词：1 6-二磷酸果糖 体外循环 血浆 细胞因子 全身炎症反应 术后并发症 

分 类 号：R654.1[医药卫生—外科学] R977.6[医药卫生—临床医学]