异丙酚对体外循环患者核因子κB活性及整合素CD11b表达影响.docVIP

异丙酚对体外循环患者核因子κB活性及整合素CD11b表达影响 　 作者：蔡伟华， 曹殿青， 张晓春 【摘要】 目的：观察异丙酚对体外循环（CPB）患者中性粒细胞（PMN）核因子κB（NF-κB）活性及整合素CD11b表达的影响。 方法：将30例行CPB心瓣膜置换术病例随机分成观察组（异丙酚麻醉维持组）和对照组（咪唑安定麻醉维持组），每组30例。分别于麻醉前、CPB开始后30min、CPB停止后30min、4h、24h抽取挠动脉血3ml，运用电泳迁移率实验检测NF-κB活性，流式细胞仪检测CD11b表达水平。采用X2检验和t检验进行组间差异的统计学分析，比较两组间PMN NF-κB活性和CD11b的表达。结果：两组患者PMN NF-κB活性在CPB停止后30min达到峰值，观察组在CPB开始后30min、CPB停止后30min、4h、24h PMN NF-κB活性低于对照组；两组患者在CPB开始30min后 PMN CD11b表达水平呈递增的趋势，CPB停止后30min、4h、24h 3个时间点上观察组PMN CD11b表达水平明显低于对照组。结论：同咪唑安定相比，异丙酚可以减低CPB患者PMN NF-κB活性和CD11b表达，明显抑制体外循环患者炎症反应。 【关键词】 异丙酚； 心肺转流术； 中性粒细胞； 核因子κB 　　Effects of Propofol on NF-κB Activity and CD11b Expression of Polymorphonuclear Neutrophils in Patients Undergoing Cardiopulmonary Bypass 　　Abstract： Objective： To study the effects of propofol on the NF-κB activity and CD11b expression of polymorphonuclear neutrophils in cardiopulmonary bypass (CPB) patients. Method： Thirty ASA Ⅱ～Ⅲ patients undergoing cardiac valve replacement surgery with CPB were randomly divided into two groups. Anesthesia was maintained with propofol in treatment group and with midazolam in control group. 3 milliliter radial artery blood was abstracted before induction of anesthesia, 30 min after CPB, 30 min, 4 hours and 24 hours after CPB finish. NF-κB activity was tested in electrophoretic mobility shift assay (EMSA) and expression of CD11b was measured in flow cytometry. The differences between the two groups at different five time points, including were analyzed with Chi-square test and t-test. Result： The peak value of NF-κB activity was got 30 min after CPB. The NF-κB activity in treatment group was lower than that in control group 30 min after CPB, 30 min, 4 hours and 24 hours after CPB finish. Expression of CD11b showed a progressive rise in two groups at all the 5 time points in the study. The CD11b expression in treatment group was lower than that in control group on 30 min, 4 hours and 24 hours after CPB finish. Conclusion： Compared with traditional anesthesia with midazola