CAJ | 학술논문

目的:探讨以自体肺取代人工肺的体外循环方法对犬体外循环相关性炎症反应的影响.方法:将12 只杂种犬随机分为对照组及实验组(每组6只).对照组在体外循环(CPB)期间使用膜式氧合器,实验组在CPB期间使用自体肺进行氧合,两组均阻断主动脉90分钟、辅助循环30分钟, 于CPB前(T1)、转流后60分钟(T2)、停机后60分钟(T3)、停机后120分钟(T4)抽取动脉血,测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素8(IL-8)和白细胞介素10(IL-10)浓度.结果:两组实验犬血浆TNF-α、IL-6、IL-8和IL-10的浓度,在T2～T4各时点与体外循环前比较均明显增加(P＜0.01);T2～T4时点实验组血浆TNF-α、IL-6和IL-8浓度明显低于对照组(P＜0.01),IL-10浓度明显高于对照组(P＜0.05).结论:自体肺体外循环可抑制体外循环过程中促炎细胞因子TNF-α、IL-6和IL-8的释放,促进抗炎细胞因子IL-10的释放,从而减轻常规体外循环引起的全身炎症反应.
목적:탐토이자체폐취대인공폐적체외순배방법대견체외순배상관성염증반응적영향.방법:장12 지잡충견수궤분위대조조급실험조(매조6지).대조조재체외순배(CPB)기간사용막식양합기,실험조재CPB기간사용자체폐진행양합,량조균조단주동맥90분종、보조순배30분종, 우CPB전(T1)、전류후60분종(T2)、정궤후60분종(T3)、정궤후120분종(T4)추취동맥혈,측정혈장종류배사인자α(TNF-α)、백세포개소6(IL-6)、백세포개소8(IL-8)화백세포개소10(IL-10)농도.결과:량조실험견혈장TNF-α、IL-6、IL-8화IL-10적농도,재T2～T4각시점여체외순배전비교균명현증가(P＜0.01);T2～T4시점실험조혈장TNF-α、IL-6화IL-8농도명현저우대조조(P＜0.01),IL-10농도명현고우대조조(P＜0.05).결론:자체폐체외순배가억제체외순배과정중촉염세포인자TNF-α、IL-6화IL-8적석방,촉진항염세포인자IL-10적석방,종이감경상규체외순배인기적전신염증반응.
Objective:To determine the protective effect of cardio-pulmonary bypass(CPB) with autologous lung as oxygenator on CPB-relative inflammatory response.Methods:Twelve adult mongrel dogs were randomly divided into control group and study group.Cardiopulmonary bypass (CPB) using a membrane oxygenator (control group) or using the autologous lung (study group) for gas exchange was performed for 120 min in an alternating series of 12 mongrel dogs with the heart arrested for 90 min by crystalloid cardioplegia and 30 min reperfusion.The blood samples were collected at the same time point of pre-operation(T1),60 min of cardiopulmonary bypass(T2),and 1 hour(T3),2 hours(T4) after cardiopulmonary bypass. Plasma concentration of IL-6,IL-10,TNF-α were detected with ELISA.Results:The plasma levels of IL-6,IL-8,IL-10,TNF-α in each group were significantly increased at T2,T3,T4.The plasma levels of IL-6,IL-8 and TNF-α in study group were significantly lower than in the control group at T2,T3,T4.The plasma levels of IL-10 in study group were significantly higher than the levels in control group at T2,T3,T4.Conclusion:This study indicates that extracorporeal circulation with autologous lung as oxygenator could reduce the increased amplitude of plasma levels of TNF-α,IL-6 and IL-8 whereas enhance the increased amplitude of the plasma IL-10 levels that result from CPB.In other word,extracorporeal circulation with autologous lung as oxygenator possesses the effect to regulate inflammatory cytokine balance and down-regulate CPB-relative inflammatory response.