【摘要】 目的观察甘草次酸对心内直视手术患者肺损伤的保护作用。方法 40例心脏瓣膜置换术患者,随机分为甘草次酸组(Ⅰ组)和对照组(Ⅱ组)。Ⅰ组患者在麻醉诱导后用甘草次酸2.5 mg/kg加入10%葡萄糖100 ml静脉泵注,而Ⅱ组只用10%葡萄糖100 ml静脉泵注,在心肺转流即刻(T0)、停心肺转流30 min(T1)、1 h(T2)、4 h(T3)、12 h(T4)取静脉血测定肿瘤坏死因子-α(TNF-α),白细胞介素(IL-6)、白细胞介素8(IL-8)含量,同时取桡动脉血做血气分析,按公式计算呼吸指数(RI)。结果两组患者无死亡,无明显肺部并发症。与转流前比较:RI在停转流后两组患者均有明显升高(P<0.05或P<0.01);两组TNF-α在T1、T2时明显升高(P<0.05);两组IL-6在T1、T2、T3时明显升高(P<0.05或P<0.01);IL-8Ⅱ组在停转流后各时点均明显升高(P<0.05或P<0.01),Ⅰ组仅T2时升高(P<0.05)。组间比较,Ⅱ组患者在T1、T2、T3时TNF-α、IL-6、IL-8及RI值均明显高于Ⅰ组(P<0.05)。结论甘草次酸可通过抑制心肺转流所致的炎性反应起到有效防治肺损伤的作用。更多还原

【Abstract】 Objective To investigate the protective effects of diammonium glycyrrihizinate on lung injury in open heart surgery.Methods 40 patients scheduled for cardiac valve replacement were divided randomly into two groups,with 20 cases for each.After anesthesia induction,2.5mg/kg of diammonium glycyrrihizinate and 100 ml of D10/W was given intravenously in group Ⅰ and 10 ml of D10/W to group Ⅱ.TNF-α,IL-6 and IL-8 was measured immediately before cardiopulmonary bypass(CPB)(T0),30 minutes(T1),1-(T2),4-(T3) and 12 hours(T4) after CPB.Respiratory Index(RI) was also calculated in both groups.Results There was no death and severe pulmonary complication in both two groups.Compared with T0,RI at T1 to T4,TNF-α at T1 and T2 and IL-6 at T1 to T3 was increased obviously in both two groups(P<0.05 or P<0.01);the levels of IL-8 was increased at T2 in group Ⅰ and at every time points after CPB in groups Ⅱ(P<0.05 or P<0.01).Compared with group Ⅱ,the levels of TNF-α,IL-6,IL-8 and RI of group Ⅰ were significantly lower at T1,T2 and T3(P<0.05).Conclusion Diammonium glycyrrihizinate can prevent and cure pulmonary injury in open heart surgery by restraining CPB-induced inflammatory response.更多还原