【摘要】 目的探讨体外循环(CPB)术前应用阿魏酸钠(SF)减轻肺缺血再灌注损伤(IRI)的作用和机制。方法CPB手术对照组20例和试验组20例。试验组术前1周用SF0.2g加入生理盐水150ml中静脉滴注,2次/d;对照组滴注平衡盐溶液,其他处理两组无差别。两组在切皮前、主动脉阻断后15、30min、术后1h采桡动脉血测定肿瘤坏死因子(TNFα)、白介素6(IL6)、白介素8(IL8)、超氧化物歧化酶(SOD)值;并在主动脉阻断前、开放后15、30min分别采左、右心房血测定中性粒细胞数。两组随机取5例病人少量肺组织行病理活检。结果主动脉阻断后15、30min、术后1h两组TNFα、IL6、IL8、SOD值均较术前有显著性增高(P<0.05),试验组同时点术中各项指标测值的增高幅度显著低于对照组(P<0.05),术后SOD、TNFα值的增高幅度显著低于对照组。主动脉开放后30min对照组右心房血中性粒细胞数值明显高于左心房值(P<0.05),而试验组则无明显差异。肺组织活检试验组中性粒细胞浸润明显少于对照组(P<0.05)。结论在CPB手术前使用阿魏酸钠可有效的抑制炎症反应,减轻肺组织缺血再灌注损伤。更多还原

【Abstract】 Objective To study the protective effect of sodium ferulate (SF) on CPB-induced lung ischemia reperfusion injury (IRI) and discuss its possible mechanism. Methods 40 patients undergoing CPB were randomly divided into contral group(CCG, n=20 ) and SF group(SFG, n=20). In SFG, SF was injected (0.2 g in NS 150 ml) intravenously Bid for one week preoperatively. In CCG, SF was replaced by same volume of NS. The changes of TNF-α、IL-6、IL-8、SOD level in the CCG and SFG would be examined before operation, at 15min、30 min after aortic cross clamp(ACC) and 1 hour after operation. By the time of before ACC、15 min and 30 min after ACC was opened, blood samples were taken from the right and left atrium to examine the amount of neutrophils. Lung tissues were cut for pathological studies in 5 patients in each group randomly. Results At 15 min、30 min after ACC and 1h after operation TNF-α、IL-6、IL-8、SOD levels of 2 groups were significantly higher than that before the operation (P<0.05).At 15 min、30 min after ACC, IL-6、IL-8 SOD level was higher in CCG than SFG (P<0.05), SOD 、TNF-αlevel was higher in CCG than SFG at 1h after operation . The neutrophils number of right atrium in CCG was much higher than that of left atrium at 30min after ACC was opened (P<0.05).Pathological study of lungs revealed that more alveolar hemorrhage and neutrophil accumulation were observed in the CCG compared to the SFG. Conclusion SF could obviously reduce the activation of systemic inflammatory reaction, prevent lung IRI during and after CPB.更多还原