摘要
目的 寻找围体外循环 (CPB)期心肌炎症活性的直接证据。方法 随机选择 2 0例接受CPB手术的病人 ,于CPB前后及CPB期间获取心肌样品以酶联免疫法 (ELISA)检测核因子κB(NF κB)活性 ,同时测定围术期血浆肿瘤坏死因子 α(TNF α)浓度 ,分析NF κB和TNF α的变化规律以及与影响因素之间的相关性。结果 (1)CPB前 17例病人心肌NF κB活化 ,CPB后 19例病人心肌NF κB活性较CPB前明显增加 ;(2 )心肌NF κB活化程度与血浆TNF α浓度变化呈正相关 ;(3)心肌NF κB活化程度与临床结果及影响因素无明显相关性。结论 CPB前心肌即可能存在炎症活性 ,CPB可能导致心肌NF κB活性增高。
Objective: To seek the direct evidence of myocardial inflammatory activation in a cohort of patient undergoing surgery on cardiopulmonary bypass (CPB). Methods: Twenty patients undergoing surgery on CPB had plasma samples obtained for tumor necrosis factor-α (TNF-α), perioperatively. Myocardial tissue samples were obtained intraoperatively, both pre-and post-CPB. Myocardial nuclear factor κB (NF-κB) nuclear translocation and plasma TNF-α concentrations were analyzed by standard enzyme-linked immunosorbent assay (ELISA). Cross clamp times, CPB times and the time to extubation were recorded. The change of myocardial NF-κB nuclear translocation and plasma TNF-α concentrations was assessed by analysis of variance (ANOVA). The regression analysis was utilized to define the correlations among the optical densities of NF-κB, concentrations of plasma TNF-α, influencing factors and heart function. Results: (1) Seventeen patients had NF-κB nuclear translocation before initiation of CPB, the optical density (OD) of myocardial NF-κB was significantly increased at the end of CPB in nineteen patients. (2) The correlation between the activity of NF-κB and concentration of TNF-α was signi ficant. (3) The correlation between the activity of NF-κB and clinic outcomes and other influencing factors was not significant. Conclusion: Myocardial inflammatory activation may be present in the patients before CPB. CPB could increase the activity of myocardial NF-κB.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2004年第2期96-98,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
