【摘要】 目的 :观察低温麻醉非体外循环与体外循环对炎性细胞因子的影响。方法 :选择心脏间隔缺损修补术患者 2 0例 ,分为体外循环 (对照组 ) 1 0例 ,体表低温麻醉 (治疗组 ) 1 0例。分别于切皮前 ( T1) ;缝合心脏缺损时 ( T2 ) ;关胸前 ( T3) ;术后 3h( T4 )时间点抽血。采用放射免疫分析法测定血浆 TNF- α、IL- 6和 IL- 8浓度。结果 :TNF- α:对照组的 T2 、T4 时间点显著升高 ( P<0 .0 5 ) ,T3升高非常显著 ( P<0 .0 1 )。治疗组 T2 、T3显著升高 ( P<0 .0 5 )。两组间比较 T3、T4 对照组高于治疗组 ( P<0 .0 5 )。IL- 6:对照组 T2 、T3升高显著 ( P<0 .0 1 ,P<0 .0 5 )。治疗组 IL- 6升高没有统计学意义。组间比较 T3对照组显著高于治疗组 ( P<0 .0 5 )。IL- 8:对照组 T2 、T3显著升高 ( P<0 .0 5 ,P<0 .0 1 )。治疗组 T3升高显著 ( P<0 .0 5 )。T2 、T3时间点对照组高于治疗组 ( P<0 .0 5 ,P<0 .0 1 )。结论 :低温麻醉非体外循环心脏直视手术对促炎性细胞因子的产生影响程度低。体外循环是心脏直视手术时炎性细胞因子产生的重要因素更多还原

【Abstract】 Objective: To investigate the effects of hypothermic anesthesia off-pump and cardiopulmonary bypass(CPB) on proinflammatory cytokines in patients undergoing open heart surgery. Methods: Twenty patients with cardiac function class Ⅰ-Ⅱ scheduled for repair of ventricular septal defect and atrial septal defect were randomly divided into two groups: Off-pump group (group O, n=10); CPB group (group C, n=10). Blood samples were taken before skin incision (T 1 ),while sewing up the septal defect (T 2 ), before closing the sternum (T 3 ), and 3 h (T 4 ) after termination of the operation for determination of plasma TNF-α, IL-6 and IL-8 concentration. Results: TNF-α level was lower at T 3 and T 4 in group O than in group C (P<0.05) . IL-6 level was lower at T 2 in group O than in group C (P<0.05 ). IL-8 level was lower at T 2 and T 3 in group O than in group C (P<0.05, P<0.01). Conclusion: There are minimum effects on proinflammatory cytokines in hypothermic anesthesia off-pump. It is the main agent on CPB-induced proinflammatory cytokines.更多还原