中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
7期
65-67
,共3页
异丙酚%体外循环%白细胞介素-6%白细胞介素-10%心脏瓣膜置换术
異丙酚%體外循環%白細胞介素-6%白細胞介素-10%心髒瓣膜置換術
이병분%체외순배%백세포개소-6%백세포개소-10%심장판막치환술
Propofol%Cardiopulmonary bypass%Interleukin-6%Interleukin-10%Heart valve replacement
目的 探讨体外循环过程中异丙酚对心脏瓣膜置换术患者血清白细胞介素(IL)-6及IL-10含量的影响.方法 选择ASA Ⅲ级,预计主动脉阻断时间和体外循环时间分别在30、60 min以上的风湿性心脏瓣膜病患者30例,随机分为对照组(C组)和异丙酚组(P组),每组15例.P组在中心静脉置管后以5 mg/(kg·h)的速度输注异丙酚,分别于切皮前(T1)、主动脉阻断后30 min(T2)、CPB停机后90 min(T3)采集两组上腔静脉血检测血清IL-6和IL-10含量.结果 两组IL-6含量在T2、T3均较T1升高(P<0.05),并于T3达峰值,C组T3高于T2,差异有统计学意义(P<0.05),P组T3与T2差异无统计学意义(P>0.05);两组IL-10在T2均较T1呈下降趋势,但仅C组T2与T1之间差异有统计学意义(P<0.05),在T3均较T1、T2升高,两组T3与T2比较差异均有统计学意义(P<0.05).两组患者血清IL-6、IL-10含量,在T1、T2差异均无统计学意义(P>0.05),在T3时,P组IL-6高于C组,IL-10低于C组,差异均有统计学意义(P<0.05).结论 心脏瓣膜置换术患者围术期使用异丙酚可以抑制IL-6的释放,促进IL-10的分泌,有效地抑制体外循环引起的炎性反应.
目的 探討體外循環過程中異丙酚對心髒瓣膜置換術患者血清白細胞介素(IL)-6及IL-10含量的影響.方法 選擇ASA Ⅲ級,預計主動脈阻斷時間和體外循環時間分彆在30、60 min以上的風濕性心髒瓣膜病患者30例,隨機分為對照組(C組)和異丙酚組(P組),每組15例.P組在中心靜脈置管後以5 mg/(kg·h)的速度輸註異丙酚,分彆于切皮前(T1)、主動脈阻斷後30 min(T2)、CPB停機後90 min(T3)採集兩組上腔靜脈血檢測血清IL-6和IL-10含量.結果 兩組IL-6含量在T2、T3均較T1升高(P<0.05),併于T3達峰值,C組T3高于T2,差異有統計學意義(P<0.05),P組T3與T2差異無統計學意義(P>0.05);兩組IL-10在T2均較T1呈下降趨勢,但僅C組T2與T1之間差異有統計學意義(P<0.05),在T3均較T1、T2升高,兩組T3與T2比較差異均有統計學意義(P<0.05).兩組患者血清IL-6、IL-10含量,在T1、T2差異均無統計學意義(P>0.05),在T3時,P組IL-6高于C組,IL-10低于C組,差異均有統計學意義(P<0.05).結論 心髒瓣膜置換術患者圍術期使用異丙酚可以抑製IL-6的釋放,促進IL-10的分泌,有效地抑製體外循環引起的炎性反應.
목적 탐토체외순배과정중이병분대심장판막치환술환자혈청백세포개소(IL)-6급IL-10함량적영향.방법 선택ASA Ⅲ급,예계주동맥조단시간화체외순배시간분별재30、60 min이상적풍습성심장판막병환자30례,수궤분위대조조(C조)화이병분조(P조),매조15례.P조재중심정맥치관후이5 mg/(kg·h)적속도수주이병분,분별우절피전(T1)、주동맥조단후30 min(T2)、CPB정궤후90 min(T3)채집량조상강정맥혈검측혈청IL-6화IL-10함량.결과 량조IL-6함량재T2、T3균교T1승고(P<0.05),병우T3체봉치,C조T3고우T2,차이유통계학의의(P<0.05),P조T3여T2차이무통계학의의(P>0.05);량조IL-10재T2균교T1정하강추세,단부C조T2여T1지간차이유통계학의의(P<0.05),재T3균교T1、T2승고,량조T3여T2비교차이균유통계학의의(P<0.05).량조환자혈청IL-6、IL-10함량,재T1、T2차이균무통계학의의(P>0.05),재T3시,P조IL-6고우C조,IL-10저우C조,차이균유통계학의의(P<0.05).결론 심장판막치환술환자위술기사용이병분가이억제IL-6적석방,촉진IL-10적분비,유효지억제체외순배인기적염성반응.
Objective To explore the effects of propofol on plasma concentration of IL-6 and IL-10 in patients undergoing valve replacement during cardiopulmonary bypass(CPB). Methods Thirty patients with rheumatic heart disease whose ASA scale were Ⅲ,aortic clamping time and CPB time were estimated more than 30 and 60 minutes respectively were selected and randomly divided into two groups:the control group(group C,n=15) and propofol group(group P,n=15). There were no differences between the two groups about medication during operation except that the propofol was used for anesthesia maintenance at the speed of 5 mg/(kg·h) in group P. Blood samples from superior vena cave were taken before operation (T1), 30 min after aortic clamping (T2), 90 min after discontinuation of CPB (T3) for detecting the plasma concentration of IL-6 and IL-10. Results The IL-6 levels of the two groups at T2, T3 were higher than that at T1(P<0.05), and the level at T3 achieved crest value. The IL-6 levels of group C at T3 were higher than T2(P<0.05), but there were no significant difference between T3 and T2 in group P. The IL-10 levels of the two groups showed to descend at T2 and to step up at T3, but there were significant difference only between T2 and T1 in group C(P<0.05), while there were significant difference between T3 and T2 in the two groups(P<0.05). The IL-6 and IL-10 levels of the two groups had no significant difference at T1 and T2, but at T3 the IL-6 levels in group P were higher than that in group C(P<0.05), at the same time the IL-10 levels in group P were lower than that in group C(P<0.05). Conclusions Propofol could inhibit inflammatory response by restraining the release of IL-6 and promoting the secretion of IL-10 during cardiopulmonary bypass.
