心肺转流术后持续利尿对全身炎症反应的影响

• 作 者: 杨蓉蓉 刘锟 黄新冲 尤庆生
• 机 构: 南通大学附属医院麻醉科,南通大学附属医院心血管外科,
• 出 处: 江苏医药
• 发表日期: 2015年20期
• 关键词: Cardiopulmonary bypass Systemic inflammatory response

目的探讨持续利尿对心肺转流(CPB)术后24h内血和尿中TNF-α、IL-6和IL-8浓度的影响。方法 40例行CPB心脏手术的患者分均为两组:试验组持续静脉应用呋塞米利尿;对照组间断应用呋塞米。ELISA法检测术前和术后2、6、12和24h两组患者血和尿中的TNF-α、IL-6和IL-8浓度。结果术后12和24h,试验组血TNF-α和IL-8增长率低于对照组(P<0.01),而尿TNF-α和IL-8增长率高于对照组(P<0.05)。结论术后持续利尿可有效降低CPB患者血TNF-α、IL-6和IL-8增长率。

Objective To investigate the effects of continuous diuresis on the levels of TNF-α, IL-6 and IL-8 in blood and urine within 24h after cardiopulmonary bypass (CPB). Methods Forty patients undergoing cardiac surgery under CPB were divided into two groups: the furosemide group was given intravenous furosemide continuously in the test group, while the control group was given furosemide intermittently. The concentrations of TNF-α, IL-6 and IL-8 in blood and urine of the two groups before operation and at 2, 6, 12 and 24h after operation were detected by ELISA. Results The increase rate of TNF-α and IL-8 in the experimental group was lower than that in the control group (P <0.01) at 12 and 24 hours after operation, while the increase rate of urinary TNF-α and IL-8 in the experimental group was higher than that of the control group (P <0.05). Conclusions Continuous diuresis can effectively reduce the increase of blood TNF-α, IL-6 and IL-8 in CPB patients.