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1、乌司他丁对食管癌围术期肺炎性反应的影响南方医科大学(JSouthMedUniv)?81?乌司他丁对食管癌围术期肺炎性反应的影响陆霄云L,'曾维安,林文前,陈秉学2何伟雄(华南肿瘤重点实验室//中山大学肿瘤中心麻醉科,广东广州510060:2中山大学附属第一医院麻醉科,广东广州510080)摘要:目的探讨乌司他丁对食管癌手术所致肺炎性反应的影响.方法选择40例限期行食管癌根治术患者,随机分为对照组(,l=20)和乌司他T~Jt(n=20).乌司他丁组按5000U/kg给予乌司他丁,对照组以等量生理盐水代替.于手术前(T1)
2、,术中恢复双肺通气后10min(T:),24h(T3),48h(T4)各监测时点抽取静脉血3ml,并于TI和Tz时点收集支气管肺泡灌洗液3ml.用ELISA法测定血浆及支气管肺泡灌洗液中IL-6,IL-8的浓度.结果两组患者T:,1r3,T4时点的血浆及T,时点的支气管肺泡灌洗液中IL.6及IL-8浓度均升高,与术前比较差异有显着性(P<0.01).乌司他丁组IL-6,IL-8增高幅度较C组小.两组比较有统计学差异(P<0.05).结论食管癌手术存在炎性反应,乌司他丁可抑制血浆及支气管肺抱灌洗液中IL-6及Ⅱ
3、,8浓度.关键词:食管肿瘤/外科学;手术并发症;乌司他丁;炎性反应中图分类号:R655.4文献标识码:A文章编号:1673-4254(2007)01.0081.03EffectofulinastatinoninflammatoryresponsesinducedbyoesophagectomyLUXiao-yun,ZENGWei-an,LINWen-qiall,CHENBing-xuC,HEWei-xiongDepartmentofAnesthesia,CancerCenterofSunYat-senUniversity
4、andStateKeyLaboratoryofOncologyofSouthChina,Guangzhou510060,China;ZDepartmemofAnesthesia,FirstHospitalofSunYat-senUniversity,Guangzhou510080,ChinaAbstract:ObjectiveToexaminetheeffectofulinastatin(UT1)ontheinflammatoryresponsesinducedbyoesophagectomy.MethodsFortyp
5、atientswithesophagealcancer(withoutserioushypertension,heartdisease,orrespiratoryfunctionimpairment,including34menand6womenaged46to70years)scheduledforoesophagectomyvialeftthoracotomywererandomlydividedintocontrolgroup(,l=20)andUTIgroup(,l=20).Anesthesiainduction
6、andperioperafivemanagementfollowedthesanleprotocolsinthetwogroups,andinUngroup,patientsreceived5000U/kgUT1whilethoseinthecon~olgroupweregiventhesanlevolumeofsaline.Beforeoperation(TI),10minafterrecoveryoftwo-lungventilation(T2),and24h(T3)and48h(T4)aroperation,the
7、VenOUSbloodsamplewastakenfromtheinternaljugularveinandtheplasmawasseparatedandstoredat-70℃forlateranalysisofIL-6andIL-8,vithenzyme-linkedimmunosorbentassay(ELISA).Thebronchoalveoarlavagefluid03mL)WasalsocollectedatTlandT2forIL-6andIL-8detection.ResultsIL-6,IL-8le
8、velsintheplasmaandBALFcollectedatT2-T4increasedsignificantlyaScomparedththoseinsamplescollectedatT1,andtheirpeakconcenlxationinplasmaandBALFsamplesweresimilar.
