黄芪对心脏瓣膜置换术患者细胞因子的影响

作者	单位
王峰	上海交通大学附属第一人民医院心血管外科
肖明第	上海交通大学附属第一人民医院心血管外科
廖斌	四川省泸州医学院附属医院胸心外科
卢成宝	上海交通大学附属第一人民医院心血管外科
袁忠祥	上海交通大学附属第一人民医院心血管外科
毛建强	上海交通大学附属第一人民医院心血管外科

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中文摘要:

目的探讨黄芪在心脏瓣膜置换术中对患者细胞因子的影响。方法将30例心脏瓣膜置换术患者随机分为黄芪组和对照组,黄芪组在转机前于预充液中加入黄芪注射液40 mL(10 mL相当于生药2 g)。分别于不同时点抽血5 mL,用双抗夹心酶联免疫吸附法(ELISA)检测肿瘤坏死因子(TNF-α)、白细胞介素(IL)-6、IL-8和IL-10。结果两组患者血浆中TNF-α、IL-6、IL-8、IL-10水平于切皮前差异均无统计学意义;在体外循环(cardiopuImonary bypass,CPB)结束时开始升高(P<0.05),CPB后3h达峰值而后逐渐下降,CPB后24 h TNF-α恢复到术前水平,IL-15、IL-8、IL-10已明显降低,但仍高于手术前;两组间各时点IL-6比较差异无统计学意义(P>0.05);黄芪组在CPB后各时点IL-10水平均显著高于对照组(P<0.05);CPB后3 h、6 h和12 h,黄芪组TNF-α和IL-8均较对照组降低(P<0.05)。结论黄芪可降低心脏瓣膜置换术患者术后促炎性细胞因子,提高抗炎性细胞因子(IL-10)水平,从而可能减轻炎症反应。

英文摘要:

Objective To evaluate the effect of astragalus(As)on cytokines in patients undergoing heart valve replacement(HVR).Methods Thirty patients undergoing HVR were randomized into the As group and the control group.Cardiopulmonary bypass(CPB)was set up routinely and to the As group,As injection(40 mL,10 mL containing 2 g of crude drug)was added into the prime solution just before CPB.Blood samples were collected at different time points during and after CPB for cytokines determination,including tumor necrosis factorα(TNF-α),interleukin-6(IL-6),IL-8 and IL-10 by ELISA.Results All the indexes measured were insignificantly dif- ferent between groups before skin incision,they began to increase by the end of CPB(P<0.05),reached the peak 3 h after CPB and then decreased gradually,TNF-αreturned to the baseline level 24 h after operation.Mean- while,levels of IL-6,IL-8 and IL-10 decreased obviously but still above the baseline.Comparisons between groups at different time points showed that levels of IL-6 were not different significantly(P>0.05),those of IL-10 were higher at all time points,and TNF-αand IL-8 at 3 h,6 h and 12 h after CPB were significantly lower in the As group(all P<0.05).Conclusion Astragalus may decrease the inflammation cytokine promoting factors,and in- crease the level of anti-inflammatory cytokine(IL-10),so it could attenuate the inflammation reaction in patients after HVR.

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