【摘要】 目的动态监测室间隔缺损修补术患者在心肺转流(CPB)各时段血清可溶性细胞间粘附分子(sICAM-1)、可溶性E-选择素(sE-selection)及肿瘤坏死因子α(TNF-α)的变化规律,并比较西京-90鼓泡式氧合器和希健-Ⅱ膜式氧合器对其的影响。方法选择择期行室间隔缺损修补术的患者30例,随机均分为鼓泡式氧合器组(B组)和膜式氧合器组(M组)。所有患者分别在麻醉后CPB开始前(T1)、主动脉阻断开放前(T2)、CPB结束时(T3)、术后2h(T4)、6h(T5)、24h(T6)及48h(T7)取静脉血5ml用ELISA法测定sICAM-1、sE-selection及TNF-α的浓度。结果两组患者血清中的TNF-α于T2时开始显著升高,T4时达到峰值(P<0·01)。sICAM-1于T5时开始升高,T6时达峰值。sE-selection于T4时开始升高,T5时达峰值(P<0·01)。M组大部分时点TNF-α、sICAM-1、sE-selection的浓度均低于B组。结论希健-Ⅱ膜式氧合器引起的炎症反应较轻。更多还原

【Abstract】 Objective To evaluate the effect of bubble and membrane oxygenators on inflammatory response during cardiopulmonary bypass（CPB）. Methods Thirty patients were divided into two groups with 15 cases each:group B （bubble oxygenator）,group M （membrane oxygenator）.Blood samples were taken before CPB（T₁）,before aortic unclamping（T₂）,at the end of CPB（T₃）, 2 hours after operation（T₄）,6 hours after operation（T₅）,24 hours after operation（T 6）and 48 hours after operation（T 7）, for measuring the concentrations of sICAM-1,sE-selection and TNF-α by ELISA. Results Compared to the baseline,the serum TNF-α increased significantly at T₂ and reached at the peak level at T₄（P<0.01）,sICAM-1 increased at T₅ and reached at the peak level at T₆,and sE-selectin increased markedly at T₄ and reached at the peak level at T₅（P<0.01） in both groups.The serum levels of TNF-α,sICAM-1 and sE-selectin were higher in group B than those in group M at most time points.Conclusion The inflammatory response was less with xijian-Ⅱ membrane oxygenator than that with xijing-90 bubble oxygenator.更多还原