不同滤出量平衡超滤对体外循环手术中炎性介质水平的影响

山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (8): 136-.

不同滤出量平衡超滤对体外循环手术中炎性介质水平的影响

焦齐1,2,王伟3,范全心4

1.山东大学医学院，济南 250012； 2.山东大学附属济南市中心医院心脏外科，济南 250013;
3.山东省交通医院手术室，济南 250031； 4.山东大学附属省立医院心脏外科，济南 250021

收稿日期:2011-05-19 出版日期:2011-08-10 发布日期:2011-08-10
通讯作者: 范全心(1949- )，教授，博士研究生导师，研究方向为心脏外科及体外循环。 E-mail：fanquanxin2003@yahoo.com.cn
作者简介:焦齐(1972- )，博士研究生，主治医师，研究方向为心脏外科及体外循环。

Effect of different balanced ultrafiltration volumes on inflammatory mediators during cardiopulmonary bypass

JIAO Qi1,2, WANG Wei3, FAN Quanxin4

1. School of Medicine, Shandong University, Jinan 250012， China；
2. Department of Cardiac Surgery， Jinan Central Hospital Affiliated to Shandong University, Jinan 250013， China；
3. Operating Theater， Shandong Traffic Hospital， Jinan 250031， China；
4. Department of Cardiac Surgery， Shandong Provincial Hospital Affiliated to Shandong University， Jinan 250021， China

Received:2011-05-19 Online:2011-08-10 Published:2011-08-10

摘要/Abstract

摘要：

目的探讨不同流量平衡超滤对体外循环(CPB)中炎性介质水平变化的影响。方法将80例先天性心脏病手术患儿随机分成对照组(C组)，小滤出量平衡超滤组［L组，超滤量30mL/(kg·h)］，中等滤出量平衡超滤组［M组，超滤量60mL/(kg·h)］，大滤出量平衡超滤组［H组，超滤量90mL/(kg·h)］, 各组均于体外循环停机后给予改良超滤。记录临床指标, 并分别于 CPB 开始、结束和术后 2h、12h采集动脉血标本, 检测肿瘤坏死因子(TNF-a) 、白细胞介素-6(IL- 6) 和白细胞介素-8(IL- 8) 指标。结果 C组各类炎症介质的浓度随转流时间的延长不断上升，各平衡超滤组中炎症介质的浓度在体外转流期间呈上升趋势，但上升幅度较小, CPB 结束后各炎症介质的浓度显著低于C组(P＜0.05)。各超滤组间比较，M组和H组炎性介质浓度显著低于L组(P＜0.05)，H组炎性介质浓度与M组相比，差异无统计学意义(P＞0.05)。结论超滤液量60mL/(kg·h)是较合理的平衡超滤策略。

关键词: 体外循环；平衡超滤；肿瘤坏死因子-α；白细胞介素-6；白细胞介素-8

Abstract:

Objective To explore the effect of different balanced ultrafiltration(BUF) volumes on inflammatory mediators in cardiopulmonary bypass(CBP). Methods 80 children with congenital heart disease were randomly divided into 4 groups: the control group (group C ), the low ultrafiltrate volume(UFV) group［group L, UFV=30mL/(kg·h)］, the moderate UFV group ［group M, UFV=60mL/(kg·h)］, and the high UFV group ［group H, UFV=90mL/(kg·h)］. All of the groups were given modified ultrafiltration after termination of CPB. Serum TNF-α, IL-6 and IL-8 were measured at the beginning and termination of CPB, and 2 and 12 hours postoperatively. Results During CPB, concentrations of TNF-α, IL-6 and IL-8 showed increasing trends in all groups, while the trends were less significant in UFV groups than in group C. After termination of CPB, concentrations of TNF-α, IL-6 and IL-8 were significantly lower in UFV groups than in group C. Compared among UFV groups, concentrations of TNF-α, IL-6 and IL-8 in group L were higher than those in groups M and H (P<0.05), while they had no statistically significant difference between groups M and H. Conclusion UFV=60mL/(kg · h) is more reasonable for BUF strategy.

Key words: Cardiopulmonary bypass; Balanced ultrafiltration; Tumor necrosis factor-α; Interleukin-6; Interleukin-8

中图分类号:

R654.1

焦齐1,2,王伟3,范全心4. 不同滤出量平衡超滤对体外循环手术中炎性介质水平的影响[J]. 山东大学学报(医学版), 2011, 49(8): 136-.

JIAO Qi1,2, WANG Wei3, FAN Quanxin4. Effect of different balanced ultrafiltration volumes on inflammatory mediators during cardiopulmonary bypass[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(8): 136-.

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