【摘要】 目的观察单肺通气(OLV)肺叶切除术时动脉血肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6和IL-8的变化。方法肺叶切除术患者20例分为OLV组和双肺通气(TLV)组,分别于麻醉前(T0)、机械通气后30min(T1)、1h(T2)、2h(T3)、胸内操作结束后1h(T4)、2h(T5)、术后24h(T6)、48h(T7)采桡动脉血测定TNF-α、IL-6和IL-8。结果OLV组TNF-α在T3时开始上升,T7达峰值,且明显高于TLV组(P<0·05)。两组IL-6和IL-8均在T2时开始上升(P<0·05),T5时达高峰,T6、T7时回降,但仍高于T0(P<0·05)。OLV组T3~T6时IL-6和IL-8均高于TLV组(P<0·05)。结论OLV和TLV均可导致动脉血IL-6和IL-8升高,OLV更显著;OLV可致TNF-α升高。更多还原

【Abstract】 Objective To observe the changes of tumor necrosis factor-α(TNF-α),interleukin(IL)-6 and IL-8 in patients undergoing lobectomy with one-lung ventilation(OLV).Methods Twenty patients undergoing lobectomy were randomly divided into two group OLV and group two lung ventilation(TLV).Arterial blood samples were taken before anesthesia(T0),at 30min(T1),1h(T2)and 2h(T3)during mechanical ventilation,at 1h(T4),2h(T5),24h(T6)and 48h(T7)after operation for detecting TNF-α,IL-6 and IL-8 by ELISA.Results TNF-α in group OLV was increased at T3 and reached peak level at T7,which was higher than that in group TLV at T3-T7(P<0.05).The levels of IL-6 and IL-8 in the two groups began to rise at T2(P<0.01),reached peak level at T5,and decreased gradually at T6 and T7,which were still higher than those at T0(P<0.05).The levels of IL-6 and IL-8 were higher in group OLV than those in group TLV at T2-T6(P<0.05).ConclusionBoth OLV and TLV can result in the increase of IL-6 and IL-8,especially OLV.TNF-α is increased in patients undergoing lobectomy with OLV.更多还原