摘要
目的探讨盐酸戊乙奎醚对心肺转流(CPB)后肺损伤的保护作用。方法 40例二尖瓣置换手术患者随机均分为盐酸戊乙奎醚组(P组)和对照组(C组),两组麻醉方法相同。P组在麻醉诱导后和升主动脉开放前分别缓慢静注盐酸戊乙奎醚0.02mg/kg;C组在同时点给予等容量的生理盐水。手术开始前(T1)和升主动脉开放后30min(鱼精蛋白中和后,T2)分别进行右肺中叶灌洗。测定肺灌洗液(BALF)中细胞因子白细胞介素-8(IL-8)和肿瘤坏死因子α(TNF-α)浓度;行血气分析计算肺泡-动脉氧分压差(PA-aDO2)。结果 T2时C组BALF中IL-8、TNF-α和PA-aDO2明显高于T1时和P组(P<0.05或P<0.01)。结论盐酸戊乙奎醚通过抑制炎性细胞因子释放IL-8和TNF-α,减轻CPB后的肺损伤。
Objective To evaluate the effect of penehyclidine hydrochloride on lung injury after cardiopulmonary bypass（CPB） in patients with rheumatic mitral stenosis.Methods Forty rheumatic mitral stenosis patients were randomly divided into penehyclidine hydrochloride group（group P） and control group （group C） with 20 cases each. Patients in group P received penehyclidine hydrochloride 0.02 mg/kg after induction of anesthesia and before release of the aortic cross-clamping respectively. Patients in group C received saline as control. Bronchoalveolar lavage fluid（BALF） was collected from the right middle lobe of the lung for the measurement of interleukin-8（IL-8） and tumor necrosis factor α（TNF-α）before operation （T1） and 30 min after release of the aortic cross-clamping （after protamine,T2）. Blood samples were collected from radial artery for blood gas analysis in order to calculate arterial-alveolar difference of oxygen tension（PA-aDO2）at the same time point.Results Concentrations of IL-8 and TNF-α in BALF and PA-aDO2 increased significantly at T2compared with those at T1 in group C （P0.01）,which were remarkably lower in group P than those in group C at T2 （P0.05）.Conclusion Penehyclidine hydrochloride can protect the lung from CPB by attenuating inflammatory response.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2010年第11期939-940,共2页
Journal of Clinical Anesthesiology
关键词
盐酸戊乙奎醚
心肺转流
肺损伤
TNF-Α
IL-8
Penehyclidine hydrochloride
Cardiopulmonary bypass
Lung injury
Tumor necrosis factor α
Interleukin-8
