【摘要】 【目的】研究缺血预处理(IPC)对瓣膜置换术患者细胞因子水平的影响,并探讨其机制。【方法】24例瓣膜置换手术患者,随机分为对照组(10例)和预缺血组(14例),比较两组患者细胞因子IL-6、IL-8和白细胞总数、中性粒细胞的变化。【结果】IL-6和IL-8在主动脉开放5min时已升高;术后1d时,预缺血组IL-6和IL-8明显低于对照组(P<0.05),术后3d时预缺血组IL-8即恢复至术前水平且低于对照组(P<0.05)。预缺血组白细胞总数在术后1～3d明显低于对照组(P<0.05),中性粒细胞在术后1d明显低于对照组(P<0.05)。【结论】IPC并没有减轻术中IL-6和IL-8的释放,但明显减轻了术后1～3dIL-6和IL-8的释放,IPC的迟发性保护作用可能与炎性细胞因子释放减少有关。更多还原

【Abstract】 【Objective】 To study the effect of ischemic preconditioning (IPC) on the systematic cytokine during and after the valve replacement operation and to investigate the mechanism. 【Methods】 Twenty-four patients were randomly divided into control group (n = 10) and IPC group (n = 14). The levels of IL-6 and IL-8 and the number of leucocytes and neutrocytes were measured. 【Results】 The levels of IL-6 and IL-8 increased significantly 5 min after the declamping of aorta in both groups. However, they were significantly lower in IPC group on the 1st day after operation (P < 0.05). IL-8 in IPC group returned to the preoperative level but was lower than that in the control group on the 3rd day after operation (P < 0.05). The total leukocyte count between the 1st and 3rd day (P < 0.05) and the number of neutrocytes on the 1st day (P < 0.05) of post operation in IPC group were low compared with that in control group. 【Conclusion】 IPC does not decrease the release of cytokine IL-6 and IL-8 during the operation but between the 1st and 3rd day of post operation. The delayed protective effect of IPC may be related to the reduced release of inflammatory cytokines.更多还原