乌司他丁对体外循环心脏手术患者体内tnf-α和中性粒细胞弹性蛋白酶的影响.doc

乌司他丁对体外循环心脏手术患者体内TNF-α和中性粒细胞弹性蛋白酶的影响
作者:邵东华,杭黎华,傅诚章
作者单位:,江苏镇江212001;2. 南京医科大学第一临床学院麻醉科,江苏南京 210029
【摘要】目的: 探讨围麻醉期乌司他丁对体外循环(CPB)下行心脏手术患者体内TNFΑ和中性粒细胞弹性蛋白酶(PMNE)的影响。方法: 择期心脏瓣膜置换患者24例,随机分为乌司他丁组(U组)和对照组(C组)。U组患者在麻醉后和转机时分别静脉泵注乌司他丁,泵注时间均为1 h。C组患者则给予等容积的生理盐水代替。分别于麻醉后手术前(T1),体外循环开始后30 min(T2),体外循环结束后1 h(T3),4 h (T4) 和20 h(T5)抽取颈静脉球血。采用ELISA法测定颈静脉球血TNFΑ和PMNE的浓度。结果: 与各自T1相比,两组患者血浆TNFΑ的浓度在T2,T3,T4,T5明显升高(P<<),T4达到高峰,T5开始下降。TNFΑ的浓度C组在T2,T3,T4,T5时明显高于U组。C组患者颈静脉球血PMNE浓度在体外循环开始后均明显升高(P<);U组则在T2,T3,T4明显升高(P<),T5回落接近手术前但高于手术前水平(P<)。而C组的PMNE浓度在T2,T3,T4,T5时升高幅度明显高于U组(P<)。结论: 乌司他丁可减轻CPB心脏手术患者体内的炎性反应,从而可能对CPB后机体损伤有一定的保护作用。
【关键词】乌司他丁体外循环炎性因子
Effect of ulinastatin on TNFΑ and PMNE in patient during
cardiopulmonary bypass
SHAO Donghua, HANG Lihua, FU Chengzhang, WANG Hong, YANG Yinghong
of Anesthesiology,the Affliated People's hospital of Jiangsu University,Zhenjiang Jiangsu 212001;
2. Department of Anesthesiology,the First Clinic Medical College of Nanjing Medical University,Nanjing Jiangsu 210029,China
[Abstract] Objective: To investigate the effects of ulinastatin (UTI) on TNFΑ and PMNE in patient during CPB. Methods: Twentyfour patients,undergoing elective cardiac valve replacement were randomly divided into 2 groups:UIT group (group U) and control group(group C). In group U,UTI was infused intravenously after the