体外循环致先天性心脏病手术患者血液细胞因子水平的变化.doc

???? 体外循环致先天性心脏病手术患者?血液细胞因子水平的变化 ???? ????【摘要】　目的　探讨体外循环对先天性心脏病手术患者外周血细胞因子水平的影响。　方法　以先天性心脏病手术患者为研究对象，不需体外循环的心血管手术患者作为对照，酶联免疫吸附法和生物活性法测定手术前、中、后多时间点外周血中细胞因子水平。　结果　二组患者术中和／或术后白细胞介素-2明显降低(P＜0.05)；可溶性白细胞介素-2受体、白细胞介素-6、肿瘤坏死因子-α和白细胞介素-10明显升高(P＜0.05)。　结论　手术应激和体外循环均是引起先天性心脏病患者术中和／或术后细胞因子水平改变的主要因素。　　【关键词】　先天性心脏病　　体外循环　　细胞因子The Changes of Cytokines Levels Related to Cardiopulmonary Bypass in Patients Undergoing Surgery for Congenital Heart Defects　Xiao Xijun, Zhang Chongjie, Zhao Zongrong, et al. Division of Cardiothorac Surgery and Department of Immunology, West China University of Medical Sciences, Chengdu 610041, P.R.China　　【Abstract】　Objective　To examine the effect of cardiopulmonary bypass(CPB) on cytokines levels of peripheral blood in patients undergoing surgery for congenital heart defects.　Methods　The possible differences between patients undergoing surgery for congenital heart defects(CPB group, n=10) and those receiving closure of patent ductus arteriosus or pericardiectomy(no-CPB group, n=9) were evaluated. Venous blood levels of interleukin-2(IL-2),soluble interleukin-2 receptor(sIL-2R),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α), and interleukin-10(IL-10) were measured by means of biological activity assay or enzyme-linked immunosorbent assays at multiple time points before, during, and after operation.　Results　As compaired with pre-operative values, IL-2 levels decreased significantly in both groups (P＜0.05), and the levels of sIL-2R, IL-6, TNF-α, IL-10 increased significantly in both groups at multiple time points after operation(P＜0.01). Although there were no pre-operative differences in these cytokines between the two groups(P＞0.05), the post-operative changes of cytokines in CPB group was more obvious than that in no-CPB group(P＜0.01). There also was a preceding IL-10 peak value, as compared with the peak values of IL-6 and TNF-α in CPB group.　Conclusion　The results suggest that besides surgical stress mediated cytokines respones, CPB itself al