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米力农和硝酸甘油对心肺转流心脏手术炎性反应的影响比较 被引量：1

Comparison of milrinone and nitroglycerin in terms of inflammatory responses during cardiac surgery with cardiopulmonary bypass
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摘要 目的探讨米力农和硝酸甘油对心肺转流心脏手术患者血浆中P选择素(CD62P)、白细胞介素8(IL8)和白细胞介素10(IL10)水平的不同影响。方法24例择期行心肺转流(CPB)下心瓣膜置换手术的患者,ASA分级Ⅲ～Ⅳ级,随机、双盲分为两组,即米力农组(M组)和硝酸甘油组(N组),每组12例。分别于麻醉前(基础T1)、主动脉开放后10min(T2)和术毕(T3)抽取患者中心静脉血,测定P选择素、IL8和IL10血浆水平。结果两组CD62PT2和T3值均较T1增高,N组T3值高于T2值,M组CD62P在T3时低于N组(P<0.05)。两组IL8值在T2和T3均高于T1,且T3高于T2(P<0.05),有持续增高趋势;N组IL8值在T2和T3时较M组值显著升高(P<0.05)。M组IL10值在T2和T3时均较T1显著增高,而N组仅在T2时增高,在T3时较T2显著降低(P<0.05);M组IL10值在T2和T3均显著高于N组(P<0.05)。结论米力农对心肺转流心脏手术时血浆炎性反应介质的调理作用强于硝酸甘油。 Objective To evaluate the effects of milrinone and nitroglycerin on inflammatory responses during replacement of cardiac valve with cardiopulmonary bypass （ CPB ）. Methods Twenty-four ASA Ⅲ-Ⅳ adult patients undergoing elective cardiac valve replacement with CPB were randomly divided into two groups： group M （n = 12 ） with milrinone infusion bv vein and group N （n = 12） with nitroglycerin infusion by vein. Blood sample was drawn from the center vein before induction of anesthesia （ T1 ） , at 10 rain of reperfusion after release of the aortic cross-clamp （T2 ） and at the end of the operation （T3 ） respectively. Concentrations of CD62P were measured using a quantitative sandwich enzyme linked-immunosorbent assay （ELISA）. The concentration of IL-8 and IL-10 on blood serum was measured with radioimmunoassay （RIA）. Results CD62P and IL-8 at T2 and T3 were higher than that at T1 in both groups while CD62P at T3 was higher than that at T2 in group N IL-8 at T3 was higher than that at T2 in both groups（ P 〈0. 05 ）. Compared with group N, CD62P at T3 and IL-8 at T2 and T3 were lower group M, but IL-10 ar T2 and T3 was higher in group M （P〈0.05）. IL-10 at T2 and T3 was higher than that at T1 in group M and IL-10 at T2 was higher than at T1 in group N （P 〈 0. 05 ）. Conclusion Continuous infusion of milrinone may produce a less inflammatory responses than that . of nitroglycerin during replacement of cardiac valve with CPB
作者 钱梅 方能新 曾一平 张健 胡兴敬 徐志荣
机构地区 安徽医科大学第一附属医院麻醉科
出处 《安徽医科大学学报》 CAS 北大核心 2005年第6期578-580,共3页 Acta Universitatis Medicinalis Anhui
基金 安徽省科技厅重点科研项目(编号:01041182) 安徽省教育厅2002年资助项目(编号:2002kj171)
关键词 米力农/药理学 硝酸甘油/药理学 心脏瓣膜 人工 心肺转流术 P选择素 白细胞介素8 milrinone/pharmacology nitroglycerin/pharmacology heart valve prosthesis imphlantation cardiopulmo- nary bypass P-selection interleukin-8
分类号 R654.2 [医药卫生—外科学] R392.11 [医药卫生—免疫学]
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安徽医科大学学报
2005年 第6期

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