【摘要】 目的探讨米力农对患者肺内血浆中P-选择素、白细胞介素-8(IL-8)和血细胞介素-10(IL-10)水平的影响。方法24例择期行心肺转流(CPB)下心瓣膜置换手术的患者,随机双盲分为米力农组(M组)和对照组(N组),每组12例。分别于CPB转机前、主动脉开放后10min抽取患者肺动脉血(PA)和肺静脉血(PV),测定P-选择素、IL-8和IL-10水平。结果P-选择素、IL-8和IL-10在主动脉开放后10min的PA、PV中血浆浓度均较CPB转机前显著升高(P<0·05)。在主动脉开放后10min时,P-选择素在M组PV中的血浆浓度较PA中血浆浓度显著降低(P<0·05),N组下降不明显,M组PV中与N组比较显著降低(P<0·05);两组中IL-8在PV中的浓度均较PA中显著升高(P<0·05),且N组升高的幅度与M组相比更大(P<0·05);两组IL-10在PV中的浓度均较PA中显著降低(P<0·05),M组在PA及PV中均较同一时点N组值高(P<0·05)。结论米力农可减轻心瓣膜置换术CPB所致急性肺损伤。更多还原

【Abstract】 Objective To evaluate the effects of milrinone on inflammatory responses of the lungs during cardiac valve replacement under cardiopulmonary bypass （CPB）.Methods Twenty-four ASA Ⅲ-Ⅳ adult patients were randomly assigned to two groups: group M （n=12） with milrinone infusion, and group N （n=12） with lactated Ringer’s solution. Blood was drawn from the pulmonary artery （PA）（T 1 ） and the pulmonary vein （PV） （T₂ ） before CPB, at 10min of reperfusion after release of the aortic cross-clamp （T 3 and T 4 ） respectively. Concentration of P-selectin was measured using a quantitative sandwich enzyme linked-immunosorbent assay （ELISA）. The concentrations of IL-8 and IL-10 serum were measured by radioimmunoassay （RIA）. Results At 10min of reperfusion, P-selectin, L-8 and IL-10 tended to be higher at T 3 and T 4 than those before CPB （P<0.05）, P-selectin was lower at T₂ than that at T 1 in group M, and P-selectin at T 4 was lower in group M than that in group N. Concentration of IL-8 at T 4 was higher than that at T 3 in both groups and increased more significantly in group N than that in group M, and concentration of IL-10 at T 4 tended to be lower than that at T 3 in both groups, furthermore IL-10 in group A was higher than that in the same blood vessel in group N （P<0.05）. Conclusion Continuous infusion of milrinone may result in a less inflammatory responses of the lungs during cardiac valve replacement under CPB.更多还原