盐酸戊乙奎醚对先心病患儿心肺转流期间细胞因子的影响.docVIP

盐酸戊乙奎醚对先心病患儿心肺转流期间细胞因子的影响 张建辉 姜丽华 [摘 要] 目的 观察盐酸戊乙奎醚在心肺转流(CPB)中及转流后对细胞因子的影响，探讨其对先心病患儿手术中的保护作用。方法 60例先心病患儿，随机分为三组：盐酸戊乙奎醚1组（P1组）、盐酸戊乙奎醚2组（P2组）和对照组（C组），每组20例。P1组术前30分钟肌肉注射盐酸戊乙奎醚0.02mg/kg；P2组术前30分钟肌肉注射盐酸戊乙奎醚0.02mg/kg，术后24及48小时各静脉追加一次盐酸戊乙奎醚0.02mg/kg；C组术前30分钟肌肉注射阿托品0.02mg/kg。分别于术前、CPB开始30min、CPB结束时、手术后24及48小时采动脉血，运用放免法测定肿瘤坏死因子(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)的含量；术后观察唾液分泌物及胸片。结果 1．三组患儿细胞因子含量的变化：CPB后TNF-α、IL-6、IL-8生成明显增加，CPB结束时达最高值，但 P1、P2组最高值明显低于对照组C组(P0.05)。 2．术后P2组患儿分泌物明显低于P1和C组(P0.05)。 3．术后P2组肺炎发生率显著低于另两组(P0.05)。结论 术前及术后运用盐酸戊乙奎醚比单纯术前应用能更有效抑制炎症细胞因子TNF-α、IL-6、IL-8的释放，减轻了CPB后的肺部炎症，与阿托品相比更适合作为先心病患儿的麻醉前用药。 [关键词]：盐酸戊乙奎醚；心肺转流；细胞因子 Penehyclidine Influencing Infant with Congenital Heart Disease Cytokines during Cardiopulmonary- bypass Zhang Jianhui ,Jiang Lihua. Department of Anesthesia,the third affiliated Hospital,Zhengzhou University, Zhengzhou ,450052 [Abstract] Objective To study Penehyclidine influencing infant with congenital heart disease cytokines during and after cardiopulmonary bypass and it’s protection to infants.Material and Methods Sixty children suffered from congenital heart disease were studied and were randomly divided into three groups:Penehyclidine group one (group P1), Penehyclidine group two(group P2), and control group (group C),twenty cases respectively. Group P1 were intramuscularly injected Penehyclidine 0.02mg/kg thirty minutes before operation. Group P2 were intramuscularly injected Penehyclidine 0.02 mg/kg thirty minutes before operation.,24 hours and 48 hours after operation. Group C were intramuscularly injected atropine 0.02mg/kg thirty minutes before operation. By radioimmunity the arterial blood taking from the children were determined the contents of tumor necrosis factor , interleukin-2, interleukin-6 and interleukin-8 before operation, thirty minutes after CPB, the end of CPB, twenty-four hours and forty-eight hours postoperatively. Their salivary secretion and X-ray plate of chest were examined postoperatively.Res