CAJ | 학술논문

目的了解抑肽酶对心瓣膜置换术患者围术期全身炎症应答的影响。方法将接受心瓣膜置换术的16例患者随机分为：对照组(n＝8)，不用抑肽酶；治疗组(n＝8)，于预冲液中加入抑肽酶300万单位，分别于术前、停机、停机后1小时和术后1天抽取外周血2ml，收集血清用酶联免疫吸附测定(ELISA)双抗夹心法检测白细胞介素-6(IL-6)和白细胞介素-8(IL-8)。结果体外循环术后患者血清IL-6和IL-8水平升高(P＜0.05)；术后1天仍高于术前；停机后1小时治疗组IL-6水平和停机时IL-8水平低于对照组，但差别均无显著性意义(P＞0.05)。结论尽管抑肽酶有抗炎症效应，但仅预冲液中加入抑肽酶300万单位无法有效抑制心瓣膜置换术患者围术期促炎性细胞因子IL-6和IL-8的释放。
목적료해억태매대심판막치환술환자위술기전신염증응답적영향。방법장접수심판막치환술적16례환자수궤분위：대조조(n＝8)，불용억태매；치료조(n＝8)，우예충액중가입억태매300만단위，분별우술전、정궤、정궤후1소시화술후1천추취외주혈2ml，수집혈청용매련면역흡부측정(ELISA)쌍항협심법검측백세포개소-6(IL-6)화백세포개소-8(IL-8)。결과체외순배술후환자혈청IL-6화IL-8수평승고(P＜0.05)；술후1천잉고우술전；정궤후1소시치료조IL-6수평화정궤시IL-8수평저우대조조，단차별균무현저성의의(P＞0.05)。결론진관억태매유항염증효응，단부예충액중가입억태매300만단위무법유효억제심판막치환술환자위술기촉염성세포인자IL-6화IL-8적석방。
Objective　To explore the effect of Aprotintin on whole-body inflammatory response in the patients with cardiac valve replacement during perioperative period.　Methods　Sixteen patients undergoing cardiac valve replacement were randomized to control group (n＝8) which received an equivalent volume prime without aprotinin and the aprotinin therapy group (n＝8) which received 3×106 IU of aprotinin added to the priming solution of the extracorporeal circulation (ECC). Serum samples were collected before the operation, at the end of ECC, 1 h after the end of ECC and 1 d after the operation respectively. interleukin-6(IL-6) and interleukin-8(IL-8) were assayed by enzyme-linked immunoadsorbent techniques.　Results　After ECC the levels of IL-6 and IL-8 increased significantly in both groups (P＜0.05). The levels of 1d after the operation were still higher than that before the operation in both groups, but there were no statistic significance (P＞0.05). At 1h after the end of ECC, the level of IL-6 in aprotinin group was lower than that of control group (P＞0.05). At the end of ECC, the level of IL-8 in aprotinin group was lower than that of control group (P＞0.05)。　Conclusion　Although aprotinin has antiinflammatory activity, but pump prime adding aprotinin 3×106 IU only may fail to attenuate proinflammatory cytokine release (IL-6,IL-8) effectively in patients with cardiac valve replacement during perioperative period.