【摘要】 目的探讨预注乌司他丁干预对单肺通气开胸侧肺萎陷时TNA-a、IL-6浓度变化的影响。方法30例择期行单肺通气开胸的手术病人,随机分为乌司他丁组(U组,n=15)和对照组(C组,n=15)。所有病人均采用静注芬太尼、异丙酚和琥珀酰胆碱麻醉诱导,行双腔支气管插管,以恒速输注异丙酚、吸入异氟醚和间断追加潘库溴铵维持麻醉,行控制呼吸。U组在麻醉诱导后静注乌司他丁10000U.kg-1,稀释至100mL后30min内注射完毕,C组静注等量生理盐水。所有病人麻醉诱导后(T0)、单肺通气60min(T1)、术毕(T2)分别采中心静脉血3mL,应用酶联免疫法(ELISA)测定肿瘤坏死因子(TNA-a)、白细胞介素6(IL-6)的浓度。结果两组病人T0时点的TNA-a、IL-6的浓度变化无差异(P>0.05)。与C组相比,U组T1、T2时点TNA-a、IL-6浓度明显降低(P<0.01)。结论预注乌司他丁干预,可抑制单肺通气肺萎陷时TNA-a、IL-6的过度释放,可能与减轻萎陷肺损伤有关。更多还原

【Abstract】 Objective To investigate the effects of ulinastatin pretreatment on TNA-a and IL-6 in pulmonary collapse during one-lung ventilation.Methods Thirty patients with pulmonary collapse during one-lung ventilation were randomly divided into the group pretreated with ulinastatin(group U)and the group not pretreated with ulinastatin(group C).All patients were induced with intravenous injection of fentanyl,propofol and succinylcholin,and maintained with constant infusion of propofol,inhalation of isoflurane,and interruption injection of pancuronium.The patients in the group U were injected with ulinastatin at 10 000 U·kg-1,and saline in group C.Intravenous blood were drawn after induction(T0),60 min after one-lung ventilation(T1),and at the end of operation(T2).TNA-a and IL-6 were assayed with enzyme-linked immunosorbent assay(ELISA).Results There were no marked differences in TNA-a and IL-6 levels at T0 in both groups.Compared with those in the group C,TNA-a and IL-6 levels in the group U were lower at T1 and T2(P<0.01).Concusion Ulinastatin pretreatment could decrease TNA-a and IL-6 levels in pulmonary collapse during one-long ventilation,and might be related to alleviation of pulmonary injury.更多还原