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目的探讨细胞因子在婴儿先天性心脏病(CHD)围术期的变化及1,6-二磷酸果糖(FDP)对其表达的影响。方法选择2006年10月-2009年12月在本院心脏病中心接受手术治疗的CHD患儿63例。将63例CHD患儿随机分为试验组(n=30)和对照组(n=33)。试验组在体外循环(CPB)前一次性在预充液中加入FDP 200 mg.kg-1,对照组预充液中不加FDP。分别于术前、CPB后3 h和CPB后48 h取血,采用ELISA法检测CHD患儿血清TNF-α、IL-6和IL-8水平。结果试验组和对照组血清TNF-α、IL-6和IL-8水平术前比较差异均无统计学意义(Pa>0.05),CPB后3 h,对照组血清TNF-α、IL-6和IL-8水平较试验组显著升高(Pa<0.05),且2组血清TNF-α、IL-6及IL-8水平均较术前显著升高;CPB后48 h,2组患儿血清TNF-α、IL-6和IL-8水平均比较差异均无统计学意义(Pa>0.05),但较术前均仍有升高。结论 CHD患儿CPB后3 h血清细胞因子TNF-α、IL-6和IL-8水平明显升高,是导致全身炎性反应的重要因素,在预充液中加入FDP后,可明显减少血清TNF-α、IL-6和IL-8的释放,减轻全身炎性反应。
Objective To investigate the changes of cytokines during perioperative period in infants with congenital heart disease (CHD) and the effect of fructose-1,6-diphosphate (FDP) on the expression. Methods Sixty-three CHD children undergoing surgical treatment at our Cardiology Center from October 2006 to December 2009 were selected. 63 CHD children were randomly divided into experimental group (n = 30) and control group (n = 33). In the experimental group, FDP 200 mg.kg-1 was added into the prefilled liquid one time before cardiopulmonary bypass (CPB), while FDP was not added to the control group prefilled liquid. The levels of TNF-α, IL-6 and IL-8 in children with CHD were measured by ELISA before and 3 h after CPB and 48 h after CPB respectively. Results There was no significant difference in serum levels of TNF-α, IL-6 and IL-8 between the experimental group and the control group before operation (P> 0.05) The level of IL-8 was significantly higher than that of the experimental group (Pa0.05), and the levels of TNF-α, IL-6 and IL-8 in the two groups were significantly higher than those before the operation There was no significant difference in TNF-α, IL-6 and IL-8 levels between the two groups (Pa> 0.05). Conclusions The levels of serum cytokines TNF-α, IL-6 and IL-8 in children with CHD at 3 h after CPB are significantly increased, which are important factors leading to systemic inflammatory response. FDP can significantly reduce serum levels of serum TNF-α, IL-6 and IL-8 release, reduce systemic inflammatory response.