自体肺体外循环对犬体外循环相关性炎症反应的影响

J4 ›› 2010, Vol. 36 ›› Issue (1): 104-107.

自体肺体外循环对犬体外循环相关性炎症反应的影响

林柏松, 张秀和, 张柏民, 姜亦忠, 李哲, 施凯耀

（吉林大学中日联谊医院心脏外科|吉林长春 130033）

收稿日期:2009-09-21 出版日期:2010-01-28 发布日期:2010-01-28
通讯作者: 林柏松 E-mail:(Tel;0431-84995772,E-mail:denticle615@126.com)
作者简介:林柏松（1969-）|男|吉林省长春市人|副教授|医学博士|主要从事心肌保护和肺保护方面的研究。
基金资助:
吉林省科技厅科技发展计划项目资助课题（20080742）

Effect of extracorporeal circulationwith autologous lung as oxygenator on CPB-relative inflammatory response

LIN Bai-Song, ZHANG Xiu-He, ZHANG Bai-Min, JIANG Yi-Zhong, LI Zhe, SHI Kai-Yao

（Department of Cardiovascular Surgery,China-Japan Union Hospital,Jilin University,Changchun 130033,China）

Received:2009-09-21 Online:2010-01-28 Published:2010-01-28

摘要/Abstract

摘要：

目的：探讨以自体肺取代人工肺的体外循环(CPB)方法对犬体外循环相关性炎症反应的影响，阐明其作用机制。方法： 12 只杂种犬随机分为对照组和实验组（每组6只）。对照组在CPB期间使用膜式氧合器，实验组在CPB期间使用自体肺进行氧合，两组均阻断主动脉90 min、辅助循环30 min，于CPB前(T1)、转流后60 min（T2）、停机后60 min（T3）、停机后120 min（T4）抽取动脉血，测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和白细胞介素10(IL-10)含量。结果：对照组和实验组犬血浆TNF-α、IL-6和IL-10水平在T2～T4各时点与体外循环前比较均明显增加(P<0.01)；T2～T4时点实验组犬血浆TNF-α和IL-6水平明显低于对照组(P<0.01)， IL-10水平明显高于对照组(P<0.05)。结论：自体肺体外循环可抑制犬CPB过程中促炎细胞因子TNF-α和IL-6的释放，促进抗炎细胞因子IL-10的释放，提示自体肺CPB可减轻常规CPB引起的全身炎症反应。

关键词: 自体肺；炎症反应；细胞因子；体外循环

Abstract:

Abstract:Objective To determine the protective effect of cardiopulmonary bypass(CPB) with autologous lung as oxygenator on CPB-relative inflammatory response.Methods Twelve adult mongrel dogs were randomly divided into control group and experimental group.CPB using a membrane oxygenator (control group) or using the autologous lung (experimental group) for gas exchange was performed for 120 min in an alternating series of 12 mongrel dogs with 90 min heart arrest by crystalloid cardioplegia and 30 min reperfusion.The blood samples were collected at the same time point of pre-operation(T1)，60 min of CPB(T2)，and 1 h (T3),2 h (T4) after CPB．The plasma levels of IL-6，IL-10,TNF-α were detected with ELISA． Results The plasma levels of IL-6，IL-10 and TNF-α of dogs in each group were significantly increased at T2,T3 and T4(P<0.01) compared with before CPB.The plasma levels of IL-6 and TNF-α in experimental group were significantly lower than those in control group at T2,T3 and T4(P<0.01).The plasma levels of IL-10 in experimental group were significantly higher than those in control group at T2,T3 and T4(P<0.05).Conclusion Extracorporeal circulation with autologous lung as oxygenator could reduce the increased amplitude of the plasma levels of TNF-α and IL-6，whereas enhance the increased amplitude of the plasma IL-10 level.The results indicate that extracorporeal circulation with autologous lung as oxygenator can reduce the CPB-relative inflammatory respones.

Key words: autologous oxygenator;inflammatory response；cytokines;cardiopulmonary bypass

中图分类号:

R-332

林柏松, 张秀和, 张柏民, 姜亦忠, 李哲, 施凯耀. 自体肺体外循环对犬体外循环相关性炎症反应的影响[J]. J4, 2010, 36(1): 104-107.

LIN Bai-Song, ZHANG Xiu-He, ZHANG Bai-Min, JIANG Yi-Zhong, LI Zhe, SHI Kai-Yao. Effect of extracorporeal circulationwith autologous lung as oxygenator on CPB-relative inflammatory response[J]. J4, 2010, 36(1): 104-107.

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