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目的 :探讨体外循环 (CPB)围术期血浆基质金属蛋白酶 9(MMP 9)和细胞因子之间的关系。方法 :选择 3 0例接受CPB的病人 ,分别在CPB开始前、开始后 3 0min、结束时、结束后 2h采集血标本 ,采用酶联免疫吸附分析方法检测血浆MMP 9和TNF α、IL 8、IL 6的浓度。结果 :(1)血浆MMP 9和TNF α、IL 8的浓度在CPB期间呈逐渐升高 ,在CPB结束时达到最高峰值 ,之后呈下降趋势 ,IL 6在CPB结束后仍继续升高。 (2 )围CPB期血浆MMP 9与TNF α、IL 8、IL 6之间均呈明显的正相关性。结论 :CPB期间血浆MMP 9、TNF α、IL 8、IL 6释放均明显增加 ,除IL 6外在CPB结束时达到最高峰值 ,围CPB期细胞因子可以诱导MMP 9的激活和释放 ,同时MMP 9可以通过对细胞因子的正反馈作用而参与CPB过程的炎症反应。
Objective: To investigate the relationship between plasma matrix metalloproteinase 9 (MMP 9) and cytokines during perioperative period of cardiopulmonary bypass (CPB). Methods: Thirty patients with CPB were enrolled in this study. Blood samples were collected before CPB, at 30 min after priming, at the end of priming and at 2 h after priming. Plasma levels of MMP 9, TNF α, IL 8 and IL - 10 were measured by enzyme linked immunosorbent assay (ELISA) IL 6 concentration. Results: (1) The concentrations of plasma MMP 9, TNFα and IL 8 increased gradually during CPB and peaked at the end of CPB, then decreased. IL 6 continued to increase after CPB. (2) There was a significant positive correlation between plasma MMP 9 and TNFα, IL 8 and IL 6 in peri-CPB period. CONCLUSION: The release of plasma MMP 9, TNFα, IL 8 and IL 6 were significantly increased during CPB. The highest peak was reached at the end of CPB except for IL 6. The activation and release of MMP 9 were induced by CPB cytokines, while MMP 9 Inflammation of the CPB process can be involved by a positive feedback on cytokines.