盐酸戊乙奎醚对先心病患儿心肺转流期间细胞因子的影响

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1、盐酸戊乙奎醚对先心病患儿心肺转流期间细胞因子的影响作者单位：450052郑州市，郑州大学第三附属医院麻醉科张建辉姜丽华[摘要]目的观察盐酸戊乙奎醚在心肺转流(CPB)中及转流后对细胞因子的影响，探讨其对先心病患儿手术中的保护作用。方法60例先心病患儿，随机分为三组：盐酸戊乙奎醚1组（P1组）、盐酸戊乙奎醚2组（P2组）和对照组（C组），每组20例。P1组术前30分钟肌肉注射盐酸戊乙奎醚0.02mg/kg；P2组术前30分钟肌肉注射盐酸戊乙奎醚0.02mg/kg，术后24及48小时各静脉追加一次盐酸戊乙奎醚0.02mg/kg；C组术前30分钟肌肉注射阿托品0.02mg/kg。分别于术前、

2、CPB开始30min、CPB结束时、手术后24及48小时采动脉血，运用放免法测定肿瘤坏死因子(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)的含量；术后观察唾液分泌物及胸片。结果1．三组患儿细胞因子含量的变化：CPB后TNF-α、IL-6、IL-8生成明显增加，CPB结束时达最高值，但P1、P2组最高值明显低于对照组C组(P<0.05)。2．术后P2组患儿分泌物明显低于P1和C组(P<0.05)。3．术后P2组肺炎发生率显著低于另两组(P<0.05)。结论术前及术后运用盐酸戊乙奎醚比单纯术前应用能更有效抑制炎症细胞因子TNF-α、IL-

3、6、IL-8的释放，减轻了CPB后的肺部炎症，与阿托品相比更适合作为先心病患儿的麻醉前用药。[关键词]：盐酸戊乙奎醚；心肺转流；细胞因子PenehyclidineInfluencingInfantwithCongenitalHeartDiseaseCytokinesduringCardiopulmonary-bypassZhangJianhui,JiangLihua.DepartmentofAnesthesia,thethirdaffiliatedHospital,ZhengzhouUniversity,Zhengzhou,450052[Abstract]ObjectiveTostud

4、yPenehyclidineinfluencinginfantwithcongenitalheartdiseasecytokinesduringandaftercardiopulmonarybypassandit’sprotectiontoinfants.MaterialandMethodsSixtychildrensufferedfromcongenitalheartdiseasewerestudiedandwererandomlydividedintothreegroups:Penehyclidinegroupone(groupP1),Penehyclidinegrouptwo(g

5、roupP2),9andcontrolgroup(groupC),twentycasesrespectively.GroupP1wereintramuscularlyinjectedPenehyclidine0.02mg/kgthirtyminutesbeforeoperation.GroupP2wereintramuscularlyinjectedPenehyclidine0.02mg/kgthirtyminutesbeforeoperation.,24hoursand48hoursafteroperation.GroupCwereintramuscularlyinjectedatr

6、opine0.02mg/kgthirtyminutesbeforeoperation.Byradioimmunitythearterialbloodtakingfromthechildrenweredeterminedthecontentsoftumornecrosisfactor,interleukin-2,interleukin-6andinterleukin-8beforeoperation,thirtyminutesafterCPB,theendofCPB,twenty-fourhoursandforty-eighthourspostoperatively.Theirsaliv

7、arysecretionandX-rayplateofchestwereexaminedpostoperatively.Results1.Thecytokinechangeinthreegroups:AfterCPB,thevalueofTNF-α、IL-6、IL-8inthreegroupswassignificanthigh.AttheendofCPBthevaluewasthehighest,andthehighestvalueofgro