川芎嗪对体外循环患者血浆中性粒细胞弹性蛋白酶及sICAM-1的浓度影响

目的探讨川芎嗪对体外循环（CPB）下行心脏手术患者体内可溶性细胞间黏附因子-1（sICAM）和中性粒细胞弹性蛋白酶（PMNE）的影响。方法将40例非紫绀型先心病患者随机分为对照组和实验组，实验组麻醉诱导后经颈内静脉滴注川芎嗪3mg／kg。对照组给予等量的生理盐水。两组分别于转机前，阻断15min，开放30min，开放60min分别抽取中心静脉血，检测其中sICAM的浓度和PMNE的浓度。结果与各自T1相比，两组患者血浆sICAM的浓度在T2，T3，T4明显升高（P〈0．05），T3达到高峰，T4开始下降。sICAM的浓度对照组在，T2，T3，T4时明显高于实验组。两组患者颈静脉球血PMNE浓度在体外循环开始后均明显升高（P〈0．01）；T3达到高峰，T4开始下降。而对照组的PMNE浓度在他，T3，T4时升高幅度明显高于实验组（P〈0．01）。结论川芎嗪可减轻CPB诱发的sICAM和PMNE的增高，对CPB后血管内皮损伤有一定的保护作用。

Effect of Ligustrazine on Plasma sICAM and PMNE during Cardiopulmonary Bypass

Objective To investigate the effects of ligustrazine on sICAM and PMNE during cardiopulmonary bypass （CPB） in patients undergoing heart surgery. Methods Forty patients with non cyanotic type congenital heart disease were divided into the control group and the treatment group. The ligustrazine（ 3 mg/kg） was administered by internal jugular vein dripping after anesthesia in the treatment group, while isometrical normal saline in the control group. Blood sample were collected form radical artery at the time points of after anesthesia induction （ T1 ）, 15 min after beginning CPB （ T2）, 30 min （ T3 ） and 60min （T4） after opening aorta, respectively, and the plasma contents of sICAM and PMNE were determined. Results The concentration of sICAM elevated dramatically at T2 ,T3 ,T4 in both groups（ P 〈 0.05 ）, and began to decease at T4 point as compared to T1. The degree of increasing in the treated group was lower the that in the control group. The concentration of PMNE from jugular bulb increased significantly after CPB （ P 〈0.01 ） in both groups ; At T4 point the concentration of PMNE decreased and was proximal to the level prior to CPB. Compared with the treated group, the rising extent of PMNE was higher at T2,T3,T4 in the control group. Conclusion Ligustrazine can reduce slCAM and PMNE induced by CPB and relieve the injury on vascular endothelial cells.