乌司他丁对心脏瓣膜置换术患者炎性因子的影响.doc

乌司他丁对心脏瓣膜置换术患者炎性因子的影响 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：乌司他丁对心脏瓣膜置换术患者炎性因子的影响 1 1 资料与方法 3 2 结 果 4 3 讨 论 5 文2：乌司他丁对心脏瓣膜置换术患者炎性因子的影响 7 1 资料与方法 9 2 结 果 10 3 讨 论 11 参考文摘引言： 13 原创性声明（模板） 14 文章致谢（模板） 15 正文 乌司他丁对心脏瓣膜置换术患者炎性因子的影响 文1：乌司他丁对心脏瓣膜置换术患者炎性因子的影响 and inflammatory respoe resulting from cardiopulmonary bypass(CPB) in cardiac valve replacement Thirty-six patients scheduled for elective cardiac valve replacement with CPB were randomly divided into two groups of 18 each: control group(C) and ulinastatin group(U). Group U received ulinastatin ×104 U/kg and group C received same volume of normal saline itead of ulinastatin as control. Blood samples were taken from radial artery for determination of plasma TNF-α, IL-6 and IL-10 concentratio before induction of anesthesia(T1), 1 h after start of CPB (T2), 1 h after (T3) and 24 h(T4) after termination of CPB. All of these was estimated by enzyme-linked immunosorbent assay(ELISA).RESULTS There was no signif icant difference between two groups in plasma TNF-α , IL-6 and IL-10 level at T1. The level of TNF-α, IL-6 and IL-10 was significantly increased at T2-T4 compared with that before CPB(T1) in both groups. However, the plasma concentratio of TNF-αand IL-6 were significantly lower while the level of IL-10 was significantly higher in group U than those in group C at Ulinastatin could reduce the increased amplitude of plasma levels of TNF-αand IL-6, whereas enhance the increased amplitude of the plasma IL-10 levels that result from CPB in cardiac valve replacement. In other word, Ulinastatin posseses the effect to regulate inflammatory cytokines balance and down-regulate inflammatory respoe during CPB. Key words： Cardiopulmonary bypass; Inflammatory respoe; Cytokines 在心血管手术中，体外循环（cardiopulmonary bypass, CPB）能引起严重的全身炎症反应，加重术前已有的心肺功能损伤，导致术后并发症发生［1］ 因此，探索行之有效的防治措施降低CPB引发的全身炎症反应一直很受关注。本研究将其应用于风湿性心脏病瓣膜置换手术，通过观察围手术期血浆肿瘤坏死因子-α(TNF-α)，白细胞介素-6(IL-6)，白细胞介素-10(IL-10)的浓度变化 规律 ，探讨乌司他丁干预对体外循环所致全身