体外循环对细胞因子的影响及干预研究

目的探讨体外循环（CPB）后细胞因子的变化及1,6-二磷酸果糖（FDP）在减少细胞因子释放中的作用。方法将63例先心病患儿按随机数字表法分为2组,观察组30例,在CPB前一次性在预充液中加入FDP200 mg.kg-1;对照组33例,预充液中不加FDP。2组分别于术前,CPB后3、48 h采集静脉血3 mL,采用ELE-SIA方法检测肿瘤坏死因子（TNF-α）、白介素6（IL-6）及白介素8（IL-8）水平的变化。结果 2组术前及CPB后48 h TNF-α、IL-6、IL-8水平变化比较差异无统计学意义（P〉0.05）;CPB后3 h对照组的TNF-α、IL-6及IL-8明显高于观察组（P〈0.01）。结论 CPB后细胞因子TNF-α、IL-6及IL-8明显升高,是导致全身炎症反应的重要因素,在预充液中加入FDP后,可以明显减少TNF-α、IL-6及IL-8等炎症介质的释放,减轻全身炎症反应。

Study on the Changes of Cytokines and the Effect of Intervention during Cardiopulmonary Bypass

Objective To investigate the changes of cytokines during cardiopulmonary bypass（CPB） and whether fructose 1,6-diphosphate（FDP）can reduce the cytokines which induced by cardiopulmonary bypass.Methods sixty-three patients with congenital heart diseases were randomly divided into two groups.In treated group（n=30）;FDP（200 mg·kg-1）was added into the prime fluid before CPB,but in control group（n=33）;no FDP was added.Blood samples were drawn at 3 time points：before CPB;3 h after CPB;48 h after CPB,The concentration of tumor necrosis factor-α（TNF-a）,interleukin-6（IL-6）and interleukin-8（IL-8）in plasma level were measured by ELESIA.Results The difference of concentration of TNF-α、IL-6、IL-8 levels of two groups showed no statisitic significance at before CPB and four-eight hours after CPB（P〉0.05）,but they still remained significantly high in control group at 3 hours after CPB（P〈0.01）.Conclusion The concentration of cytokines were significantly elevated after CPB which is the important factor resulting in systemic inflammatory response.FDP can reduce the concentration of TNF-α、IL-6 and IL-8 in plasma after CPB.It suggests that the FDP may alleviate the systemic inflammatory response after CPB.