葛根素预处理对体外循环围手术期细胞因子的影响

作者	单位
姜晓晓	南昌大学第二附属医院胸心外科
李勇	南昌大学第二附属医院胸心外科
吴永宾	南昌大学第二附属医院胸心外科
徐建军	大连医科大学附属第一医院心血管外科

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中文摘要:

目的探讨葛根素预处理对体外循环术(cardiopulmonary bypass,CPB)围手术期细胞因子的影响及其作用机制。方法将40例心脏病患者随机分为体外循环手术对照组(20例)和试验组(20例)。试验组于术前1周开始用葛根素0.6 g加入5%葡萄糖注射液250 mL中静脉滴注,1次/日;对照组滴注平衡盐,其他处理两组无差别。观察两组在麻醉诱导期、升主动脉阻断后10 min、开放升主动脉后10 min、2 h、12 h共5个时间点肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白细胞介素(interleukin)-6、IL-8、IL-10水平变化。结果两组患者CPB后上述参数水平开始升高,升主动脉开放后2 h时达到峰值,以后逐渐下降,但12 h仍高于术前(P<0.05),葛根素组TNF-α、IL-6、IL-8水平在各时间点上升幅度均低于对照组(P<0.01或P<0.05),各时间点IL-10水平升高幅度均高于对照组(P<0.01)。结论CPB手术前使用葛根素能有效降低促炎性细胞因子TNF-α、IL-6、IL-8的水平;增加抗炎性细胞因子IL-10的表达,从而减轻CPB术后机体的炎症反应。

英文摘要:

Objective To study the effect and acting mechanism of puerarin preconditioning(PP) on blood level of cytokines in patients undergoing cardiopulmonary bypass(CPB) in perioperative period.Methods Forty patients with heart diseases scheduled to take surgical operation were randomized into the control group and the PP group equally.They were treated with the same program,excepting that 0.6 g of puerarin was given to the PP group by adding in 5% glucose solution 250 mL for intravenous dripping every day for one week before operation,but to the control group,normal saline was given instead.The levels of tumor necrosis factor-α(TNF-α),interleukin 6,8 and 10(IL-6,IL-8,IL-10) in arterial blood were measured at 5 time points in the process of CPB,namely,anesthetic induction(T1),10 min after the clamp of the ascending aorta(T2),10 min,2 h and 12 h after the Clamped aorta is unclamped(T3,T4 and T5).Results All the above-mentioned indexes(TNF-α,IL-6,IL-8 and IL-10) gradually increased after beginning CPB,reached the peak at T4,then lowered gradually but still presented the higher levels at T5 than those at T1(P<0.05).Comparison between the two groups showed that levels of TNF-α,IL-6 and IL-8 were significantly lower(P<0.05 or P<0.01) and level of IL-10 was higher in the PP group than those in the control group respectively at all the time points(P<0.01).Conclusion Injecting puerarin before CPB could effectively suppress the pro-inflammatory cytokines like TNF-α,IL-6 and IL-8;and enhance the expression of anti-inflammatory cytokines like IL-10,thus to alleviate the inflammatory reaction induced by CPB.

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