去白细胞血对细胞因子介导心肌再灌注损伤的保护效果

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1、遵义医学院硕士学位论文去白细胞血对细胞因子介导心肌再灌注损伤的保护效果姓名：方华申请学位级别：硕士专业：麻醉学指导教师：刘兴奎;喻田2003.6.18去■■簏▲对细胞日子介导,畦llt再雌诅攫傍的保护致暴【摘要】目的探讨去白细胞J『

2、L再灌注液埘犬体外循环(㈣)中促炎悱细胞刚予引起的缺ifit心肌m淞汴损伤的保护效粜。方法成年杂利，犬，?条，根据fj；}濉注液成分不同随机分为对照组(C组)和去臼细胞血组(上组)，每组6条，两组动物经麻醉和开胸，。j，建立体外循环心肌缺皿再灌注实验模型。C组在心肌缺J[it40min后，于主动脉根部以2ml／kg

3、．min灌入晶体再灌注液．特约：2Dm加。if／iLSIL(1iIq：灌注避踏l

4、1肌川‘次性自细胞滤过器(LDF)，弭灌注液为去白细胞新鲜动脉m，余均同C组。￡组测定滤过前后衄液成分的变化。分别丁^并循5min、阻断30min及60rain和开放30rain及60rain分别取静脉lfⅡ，榆测】ffL消孙忙口、／L．朋、IL一6、IL．8浓度和lfif：常规。并于阻断前、阻断60min和开放60rain分别取心肌标本进行髓过氧化物酶(MPO)活性榆测及光镜检测。结果滤后白细胞计数娃著低于滤前：)1：放升主动脉后的备时问段，￡组的TNF-a、儿

5、．耶、IL．6和IL．排度显著低于C组。L组符¨’II目段心肌组织匀浆^护D活性显蒋低于C组；光镜检查c组开放60min心肌组织的破坏程度较I．组严最。结论CPB中应用去白细胞血再灌注液可有效地抑制促炎性细胞因子和活化白纲胞介导的心肌缺皿／秀灌注损伤而产：Ii段妤的心肌保护作川。【关键词】去白细胞血细胞因子心肌保护体外循环缺血／再灌注损伤Cardioprotectiveeffectsofleukocyte-depletedbloodoncytokine-mediatedmyocardialisc&emia-reperfasloninjurydu

6、ringcardiopMmonarybypass【Abstract】ObjectiveToelucidatetheprotectiveeffectofieukocytc—depletedbhmd071thecytokine—mediatedmyo“wdial毓2●去■■屁▲对■簏园子介导心肌再雌诅投傍曲保护致幂ischemia·reperfiIsioninjuryduringcardiopulmonarybypass(CPB)．MethodsTwelveadulthealthyhybriddogsofeithersexweighting10—1

7、5kgundergoingCPB,withconlinuousinfusionofSt．Thomas][eardioplegia，wererandomizedintotwogroups：tl'eexperimentalgroup佃26,groupL)Withituseojtheleukocytedepletionfi!ter(LDF)onthebypasscircuit．andthecontrolgroupfn=6．groupC)．AllthedogswereanesthesRizedwith25％sodiumpentobarbitone25m

8、g／kg．HelqodynamicparameterswererecordedonaSiemenssirecter一960．Aftertrachealintubation，continuousarte，Tbloodpressureandcentrevenol船pressure(C阡)weremonitoredfromfemoralarteryandfemoralveinduringCPB．Intheexperimentalgroup,thehear捃，whichweredeclamping(DC)after60minaorticCROSS—cl

9、amping例a，wereconHnuous炒reperfusedfo，20minwithleukocyte-depletedblood2ml／kg咖LDFconnectedwithbypasscircuit．ControlgroupwastreatedasgroupLbutemployingphysiologicalsalimasasubstituteforleukocyte-depletedblood．Thebloodcellsaccountbefo增andafterthefiltrationweremeasured．Thelevelsof

10、serumTNF-a、lL-l￡、IL一6andlb8weredetectedat5minfollowingCPB,30min．60rain妒crAc