摘要
目的探讨经升主动脉注射鱼精蛋白对婴儿体外循环心脏直视手术肺泡灌洗液中炎性因子的影响，进一步证实其肺保护作用机制。方法随机抽取60例（年龄≤10个月，体质量≤8kg）行体外循环心脏直视手术患儿，分为实验组（升主动脉组，30例）和对照组（中心静脉组，30例），比较两组注射鱼精蛋白前肺泡灌洗液中组胺、类胰蛋白酶及白三烯B4含量变化。结果实验组及对照组体外循环前肺泡灌洗液中组胺、类胰蛋白酶及白三烯B4含量差异均无统计学意义（P均〉0．05）；对照组注射鱼精蛋白6h肺泡灌洗液中组胺[（61．1±10．2）斗g／L与（35．4±8．9）μg／L]、类胰蛋白酶[（73．9±10．2）U／L与（56．5±7．1）U／L]及白三烯B4[（86．84-8．1）ng／L与（68．4±5．9）ng／L]均较实验组显著升高，差异均有统计学意义（t值分别为2．005、1．862、2．114，P均〈0．05）。术后机械通气时间实验组比对照组缩短[（6．3±0．8）h与（10．1±1．2）h；t=1．895，P〈0．05]。结论经升主动脉注射鱼精蛋白能够减轻婴儿体外循环心脏直视手术肺泡灌洗液中炎性因子的产生，减轻肺损伤，是一种良好的肺保护措施。
Objective To investigate the effect of intraaortic protamine injection on bronchoalveolar lavage fluid （BALF） inflammatory cytokine levels in infants undertaking opening heart operation by Cardiopulmonary Bypass,in order to verify the protective role of intraaortic protamine in lung. Methods Sixty infants（ age ≤ 10 month, weight ≤ 8 kg） undertaking opening heart operation by Cardiopulmonary Bypass were randomized into receiving intraaortic group （ the experimental group, n = 30 ） and intravenous protamine group （ the cohtrol group, n = 30）. The levels of histamine, tryptase and leukotrienes B4 in the BALF were compared between the experimental and the control groups before injecting protamine and 6 hours after injecting protamine. Results There were no significant differences in the levels of histamine, tryptase and leukotrienes B4 in the BALF between the two groups before injecting protamine（P 〉 0. 05）. The levels of histamine（ （61.1 ± 10. 2 ） μg/L vs. （ 35.4 ± 8.9 ）μg/L, t = 2. 005 ）, tryptase （ （ 73.9 ± 10. 2 ） U/L vs. （ 56. 5 ± 7.1 ） U/L, t = 1. 862） and leukotrienes B4 （ （ 86. 8 ± 8. 1 ） ng/L vs. （ 68.4 ± 5.9 ） ng/L, t = 2. 114 ） in the BALF of the intravenous protaminc groups were markedly higher compared with the intraaortic protamine groups at 6 hours after injecting protamine （ P 〈 O. 05 ）. The experimental group had significantly shorter duration of mechanical ventilation than in the control group（ （6. 3 ± 0. 8 ） h vs. （ 10. 1 ± 1.2） h, t = 1. 895,P 〈 0. 05 ）. Conclusion Intraaortic protamine injection can decrease the levels of inflammatory cytokines in the BALF and reduce lung injury. It is a good way to conduct intraaortie protamine injection for lung protection in infants undertaking opening heart operation by Cardiopulmonary Bypass.
出处
《中国综合临床》
2013年第5期477-480,共4页
Clinical Medicine of China
基金
深圳市科技计划项目（201103143）
