摘要
目的：观察乌司他丁（UTI）对青少年特发性脊柱侧凸（AIS）患者围手术期炎症因子（IL-6、TNF-α、IL-10、IL-4）表达的影响。方法：20例AIS患者，ASAⅠ～Ⅱ级，择期行侧凸矫形术，随机分为2组。UTI组（n=10）：于麻醉后手术前将10000U／kg的UTI溶于100ml生理盐水中，微泵持续静滴，若手术时间超过4h，追加1次，方法同前。对照组（n=10）：用等量生理盐水替代。术中连续监测心电图（ECG）、脉搏血氧饱和度（SpO2）、呼气末CO2分压（PETCO2）、中心静脉压（CVP）与桡动脉压，维持平均动脉压（MAP）在（60±5）mmHg（1mmHg=0．133kPa）。分别于麻醉前（T1）、诱导后10min（T2）、给药后1h（T3）、拔管后30min（T4）及术后24h（T5）抽取静脉血，测定血浆各细胞因子蛋白及其mRNA的表达。结果：在T3、T4、T5时，对照组血浆IL-6、TNF-α水平及其mRNA拷贝数明显高于T1（P〈0．05或P〈0．01）；UTI组血浆IL-6、TNF-α水平及其mRNA拷贝数与T1相比无显著差异，且明显低于对照组（P〈0．05或P〈0.01）。在T4、T5时，对照组血浆IL-10水平及其mRNA拷贝数与T1比明显升高（P〈0．05）；UTI组血浆IL-10水平及其mRNA拷贝数明显高于T1水平（P〈0．01），且明显高于对照组（P〈0．01）。两组各时间点血浆IL-4水平及其mRNA拷贝数未见显著改变。结论：UTI可抑制AIS患者围手术期促炎细胞因子IL-6、TNF-α及其mRNA产生；并可促进血浆抗炎细胞因子IL-10在蛋白与mRNA水平的增高。
Objective：To investigate the effect of ulinastatin（UTI） on the changes of IL-6, TNF-α, IL-10 and IL-4 expression during perioperative period of surgical correction of adolescent idiopathic scoliosis（AIS）. Methods： Twenty patients with AIS Ⅰ- Ⅱ scheduled to receive surgical correction of spinal deformities were equally randomized into 2 groups-UTI group and control group. Patients in UTI group received intravenous infusion of 10 000 U/kg UTI with 250 ml normal saline just before operation and every 4 h thereafter if necessary ; patients in control group received same amount of normal saline. ECG, CVP, SpO2 and PETCO2 were continously monitored during operation in both group. Mean arteral pressure （MAP） was maintained at （60±5） mmHg （1 mmHg=0. 133 kPa）. Venous blood samples were collected immediately before induction of anaesthesia （T1）,10 min after induction （T2）, 1 h after UTI administration （T3）, 30 min after extubation （T4） and 24 h postoperatively （T5）. The plasma levels of IL-6,TNF-α, IL-10 and IL-4 were measured by enzyme-linked immunosorbent assay （ELISA）, and their mRNA expression was assayed by real-time quantitative reverse transcription polymerase chain reaction. Results： At T3, T4 and T5, plasma levels of IL-6 and TNF-α and their mRNA copies in control group were significantly higher than that at T, （P〈0.05 or P〈0.01） and those in UTI group（P〈0.05 or P〈0.01） ; while plasma IL-6 and TNF-α and their mRNA copies in UTI group had no difference compared with those at T1 , but were significantly lower than those of control group （P〈0.05 or P〈0.01）. At T4 and T5 ,plasma IL-10 and its mRNA copies had a significant increase compared with those at T, in control group （P〈 0.05）. At T4 and T5, plasma IL-10 and its mRNA copies had a significant increase compared with those at T, in UTI group （P〈 0.01）, and were higher than that of control group （P〈0.01）. The plasma IL-4 and its mRNA copies had no significant change in both groups on each point time. Conclusion： UTI can inhibit the release of IL-6, TNF-α and their mRNA copies in perioperation period of surgical correction of AIS,and it may also promote expression of IL-10 protein and IL-10 mRNA.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2006年第2期203-206,共4页
Academic Journal of Second Military Medical University
