乌司他丁对体外循环过程中肺保护作用的影响

目的体外循环导致急性肺损伤，本研究在体外循环过程中应用乌司他丁后观察肺组织损伤程度的变化，及探讨肺损伤与丝裂原激活蛋白激酶（MAPK）的变化规律的关系。方法100例风湿性心脏病行二尖瓣人工机械瓣置换的病人分为Ⅰ、Ⅱ组。Ⅰ组50例，行常规体外循环，心脏阻断40—55分钟，术中持续肺灌注低温氧合机器血；Ⅱ组50例，体外循环方法同Ⅰ组，在Ⅱ组术中用乌司他丁加低温氧合机器血行肺灌注；分别在不同时段取二组病人血液标本，测量P38MAPK活性，炎症细胞因子IL-6、ID8，及术后气道峰值压力、氧指数等。结果Ⅰ组P38MAPK活性明显增高，Ⅰ组肺损伤与Ⅱ组相比加重（出现统计学差异）。结论体外循环过程中，抑制P38MAPK活性表达可减轻肺损伤，术中应用乌司他丁肺灌注有抑制肺损伤的作用，为体外循环术中肺保护提供一种切实可行的方法。

Effects of Ulinastain on protecting Pulmonary in Cardiopulmonary Bypass

Objective Purpose Pulmonary injury is produced during eardiopulmonary bypass （CPB）.Our experiment researched relation between phospho-MAPK （Mintage-activated protein kinesis） and lung injury and relation between applying Ulinastain for Injection and pulmonary injury during CPB.Methods 100 pafiences with mitral valve disease randomly distributed two groups.The first group （50 cases） and the second group laced on CPB, which included 40 - 55 min of cardiologic arrest, but the second group （50 cases） was administrated with Ulinastain for Injection into oxygenated blood while continuous lung perfnsion.we peffused the lung of the first group oxygenated blood only. Plasma samples were collected. Activated forms of p38 were measured by ELISA. ID6. IL-8 were measured. The peak pressure of airway and Oxygenation index（QI） were measured.Results phosphor-p38 of The first group were increased compared with the second group （ P 〈 0.01）. Lung injury in the first group were evident compared with the second group （ P 〈 0.01）. Conclusion The results of our study demonstrate that phospho-p38 mediate acute lung injury during CPB. P38MAPK inhibitor decreases pulmonary injury. The experiment provide a new way to prevent pulmonary dysfimction due to CPB.