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目的 探讨小儿体外循环 (ECC)术中抑肽酶促进内源性IL 10释放的作用及量效关系。方法 按入选标准筛选病例并随机分成 6组 :对照组 (A1 组 ,n =15 ) ,小剂量抑肽酶组 (B1 组 ,n =15 ) ,大剂量抑肽酶组 (C1 组 ,n =15 ) ,激素组 (A2 组 ,n =2 0 ) ,激素 +小剂量抑肽酶组 (B2 组 ,n =2 0 ) ,激素 +大剂量抑肽酶组 (C2 组 ,n =2 0 )。用酶联免疫吸附试验法测定各患儿在术前 ,ECC 30min ,ECC结束后 2h ,2 4h ,7d5个时间点血清IL 10的浓度。结果 各组ECC 30min ,ECC结束后 2h血清IL 10浓度与术前相比显著增高 (P <0 0 1) ;且B1 、C1 组与A1 组相比 ,B2 、C2 组与A2 组相比及C1 组与B1 组比较 ,C2 组与B2 组比较 ,IL 10水平增高更为明显 ,各组间差异有显著性 (P <0 0 1) ;A1 、B1 组术后住院日明显延长 (P<0 0 5 )。结论 抑肽酶能促进内源性IL 10的释放 ,且药效与抑肽酶剂量呈正相关
Objective To explore the effect of aprotinin on the release of endogenous IL-10 during cardiopulmonary bypass (ECC) and its dose-response relationship. Methods According to the inclusion criteria, the patients were randomly divided into 6 groups: control group (group A1, n = 15), low dose aprotinin group (group B1, n = 15), high dose aprotinin group (group C1, n = (Group A2, n = 20), hormone + low dose aprotinin group (group B2, n = 20) and hormone + high dose aprotinin group (group C2, n = 20) . The levels of IL-10 in serum were measured by enzyme-linked immunosorbent assay before operation, ECC 30min, 2h, 24h, 7d after ECC. Results The concentration of serum IL-10 in ECC30min group and ECC group at 2h after operation was significantly higher than that in preoperative group (P <0.01) Compared with group B1, the level of IL-10 in group C2 was significantly higher than that in group B2 (P <0.01), and the postoperative hospital stay in group A1 and B1 was significantly longer (P < 0 0 5). Conclusions Aprotinin can promote the release of endogenous IL-10, and the pharmacodynamics is positively correlated with the dosage of aprotinin