【摘要】 目的 :探讨抑肽酶对常温体外循环术中、术后炎性反应的抑制作用。方法 :4 0例常温体外循环下行心脏直视手术的风湿性心瓣膜病患者随机分为 2组。试验组 2 0例 ,于转机前加入抑肽酶 5万kIU·kg-1,对照组 2 0例未用抑肽酶。分别于麻醉前、主动脉阻断 10min、停机后 10min、术后 2 4h及术后 4 8h采取动脉血标本 ,酶标放免法分别测定血浆IL 6、IL 8及TNF α水平。结果 :2组麻醉前各因子血浆水平差异无统计学意义 (P >0 .5 ) ,对照组各因子在体外循环后各时点均升高 (P <0 .0 1) ,术后 4 8h恢复至基础值 ,而试验组各时间点各因子水平也升高(P <0 .0 5或P <0 .0 1) ,但均较对照组低 (P <0 .0 5或P <0 .0 1)。试验组与对照组相比 ,围手术期输血量及术后胸腔引流量明显减少 (P <0 .0 5 )。结论 :抑肽酶可减轻常温体外循环术中、术后患者全身炎性反应综合征 ,减少术后渗血及围手术期输血量更多还原

【Abstract】 Aim:To evaluate the effects of aprotinin on plasma IL 6,IL 8, and TNF α after warm cardiopulmonary bypass.Methods: Forty patients with rheumatism heart valves disease were randomized to aprotinin group ( n =20) and control group( n =20).The samples of each group were collected during and after cardiopulmonary bypass. IL 6,IL 8, and TNF α were measured by ELISA.Results: In control group, TNF α,IL 6, and IL 8 were significantly increased during and after cardiopulmonary bypass and returned to normal 48 hours after operation. In comparison with control group, the increasing degree of each factors were significantly lower in aprotinin group ( P <0.05) and returned to normal 24 hours after operation.Conclusion:Aprotinin may inhibit warm bypass induced imflammation of warm cardiopulmonary bypass by suppressing cytokines production such as IL 6, IL 8, and TNF α .更多还原