中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

前列地尔脂肪乳剂在体外循环冠状动脉旁路移植术中对炎症反应的作用

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目的 探讨前列地尔脂肪乳剂(liposomal prostaglandin E1, LipoPGE1)在体外循环(CPB)冠状动脉旁路移植术(CABG)中对炎症反应的作用。 方法 选取2006年7月至2008年12月锦州市中心医院32例冠心病需行CABG治疗患者,按随机数字表法分为两组,每组16例。实验
组:男9例,女7例;年龄54.4±18.1岁; CPB开始前至CPB结束持续经中心静脉泵入Lipo-PGE1[15.0 ng/(kg·min)];对照组:男9例,女7例;年龄54.8±20.4岁;除不使用Lipo-PGE1外,其他操作均与实验组相同。分别于CPB前,升主动脉开放后1 h、2 h、6 h和24 h抽取两组患者的动脉血,检测血浆白细胞介素6(IL6)、肿瘤坏死因子α(TNFα)及可溶性细胞间黏附分子1(sICAM1)的浓度,并对两组检测结果进行比较。 结果 升主动脉开放后两组血浆IL-6、TNF-α和sICAM1浓度均逐渐升高,后两者于升主动脉开放后6 h达峰值。实验组升主动脉开放后各时
间点血浆IL-6(升主动脉开放后24 h:16.1±2.2 μg/L vs. 19.2±4.5 μg/L,Plt;0.05)、TNF-α(升主动脉开放后24 h:1.8±0.4 μg/L vs. 2.2±0.5 μg/L,Plt;0.05)和sICAM-1(升主动脉开放后24 h:2336±36.6 μg/L vs. 294.2±55.7 μg/L,Plt;0.05)浓度均较对照组明显降低。 结论 Lipo-PGE-1可减轻 CPB 引起的中性粒细胞聚集,抑制血管内皮细胞的激活,减轻血管内皮细胞损伤和全身炎症反应。

Abstract: Objective To investigate the effect of liposomal pro
staglandin E1 (LipoPGE1) on inflammatory reaction during cardiopulmonary b
ypass (CPB) coronary artery bypass grafting (CABG). Methods Be
tween July 2006 and December 2008, a total of 32 patients undergoing CABG were r
andomly divided into two groups of 16 pa
tients each using a random digits table. The experimental group had 9 male and 7
female patients with a mean age of 54.4±18.1 years; each patient received 15.0
ng/(kg·min) of LipoPGE1 by venous pump through the central vein throughout
theCPB procedure. The control group had 9 male and 7 female patients with a mean a
ge of 54.8±20.4 years, who were treated identically to the experimental group e
xcept did not receive LipoPGE1. Arterial blood samples were taken before CPB
and at the 1st, 2nd, 6th, and 24th hour after open aorta ascendens. The levels of
interleukin6(IL6), tumor necrosis factorα (TNFα), and soluble interce
llular adhesion molecule1 (sICAM1) were tested and compared. Results
In both groups, levels of IL6, TNFα, and sICAM1 were all gradually increased after the as
cending aorta was opened, and they reached their highest levels at the 6th hour
after open aorta ascendens. In the experimental group, at every time point after
the ascending aorta was open, levels of IL6 (24th hour after open aorta ascen
dens: 16.1±2.2 μg/L vs. 19.2±4.5 μg/L,Plt;0.05), TNFα (24th hour after
open aorta ascendens: 1.8±04 μg/L vs. 2.2±0.5 μg/L,Plt;0.05), and sICAM
1 (24th hour after open aorta ascendens: 233.6±36.6 μg/L vs. 294.2±55.7 μg
/L,Plt;0.05) were significantly lower than those of the control group. 〖WTHZ
〗Conclusion LipoPGE1 effectively reduces the aggregation of polymo
rphonuclear neutrophilic leukocytes, inhibits activation of vascular endothelial
cells, and decreases systemic inflammatorome during CPB.

关键词: 前列地尔脂肪乳剂; 炎症反应; 体外循环; 冠状动脉旁路移植术

Key words: Liposomal prostaglandin E1; Inflammatory reaction; Cardiopulmonary bypass; Coronary artery bypass grafting

引用本文: 李卫国,谷天祥,申莲玉等. 前列地尔脂肪乳剂在体外循环冠状动脉旁路移植术中对炎症反应的作用. 中国胸心血管外科临床杂志, 2011, 18(6): 510-. doi: 复制

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