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目的探讨前列腺素E1(PGE1)对心肺转流(CPB)后全身炎性反应(SIRS)的抑制作用。方法 30例心脏手术患者随机分为对照组(15例)和实验组(15例,PGE1治疗组)。实验组于麻醉诱导时从中心静脉持续泵入PGE1(20~30 ng.kg-1.min-1)至CPB结束。分别于转流前、心脏复跳后15 min、CPB结束后2 h及6 h检测循环血中中性粒细胞(PMN)计数、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)及IL-8。结果两组心脏复跳后血PNM计数进行性升高,CPB结束后2 h达高峰。实验组CPB后2 h、6 h血PMN计数显著低于对照组(P<0.01、P<0.05);两组TNF-α、IL-6、IL-8进行性升高,于心脏复跳后达到峰值,随后逐渐下降,至CPB后6 h仍高于CPB前;对照组较实验组增高则更为显著(P<0.05)。结论 PGE1可抑制CPB引起的中性粒细胞的激活、减少炎性因子的释放并减轻由此引起的SIRS。
Objective To investigate the inhibitory effect of prostaglandin E1 (PGE1) on systemic inflammatory response (SIRS) after cardiopulmonary bypass (CPB). Methods Thirty patients with cardiac surgery were randomly divided into control group (15 cases) and experimental group (15 cases, PGE1 treatment group). The experimental group was continuously pumped PGE1 (20-30 ng.kg-1.min-1) from the central venous to the end of CPB during induction of anesthesia. The levels of neutrophil (PMN), tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), interleukin-6 -6) and IL-8. Results The blood PNM levels in the two groups increased progressively after CPB, and peaked at 2 h after CPB. In the experimental group, the PMN count at 2 h and 6 h after CPB was significantly lower than that in the control group (P <0.01, P <0.05). The levels of TNF-α, IL-6 and IL- Reached the peak value, and then decreased gradually, which was still higher than that before CPB 6 h after CPB; the control group was more significant than the experimental group (P <0.05). Conclusion PGE1 can inhibit the activation of neutrophils induced by CPB, reduce the release of inflammatory cytokines and relieve the SIRS induced by them.