乌司他丁在体外循环心脏手术中对细胞免疫功能的影响

目的:研究乌司他丁(UTI)对体外循环(CPB)心脏手术患者围术期外周血T淋巴细胞亚群、NK细胞、IL-2和 IL-6含量变化的影响. 方法:30例拟行心脏瓣膜置换手术患者,分为2组,对照组未用药,实验组用UTI. 分别于麻醉前、术后4,8,24,48,168 h测定外周血T淋巴细胞亚群、NK细胞、IL-2和 IL-6含量. 结果:对照组和UTI组患者术后4,8,24,48 h 时CD3,CD4,NK较麻醉前均下降(P＜0.05);但术后8,24,48 h UTI组CD3水平高于对照组(P＜0.05),术后4,8,24,48 h UTI组CD4高于对照组(P＜0.05),术后24,48 h UTI组NK细胞含量高于对照组(P＜0.05). 对照组患者术后4,8,24,48 h时血清IL-2含量较麻醉前降低,IL-6较麻醉前升高(P＜0.05);UTI组患者术后4,8 h时IL-2含量较麻醉前降低(P＜0.05),4,8,24,48 h时 IL-6较麻醉前升高(P＜0.05),术后4,8,24,48 h时UTI组IL-2含量高于对照组(P＜0.05,P＜0.01),术后4,8,24,48 h UTI组IL-6含量低于对照组(P＜0.05). 结论:乌司他丁对CPB患者围术期免疫功能有部分调节作用.

Effect of ulinastatin on immunological function in patients undergoing cardiac surgery during cardiopulmonary bypass

AIM: To investigate the effect of ulinastatin (UTI) on T-lymphocyte subpopulation, NK cell, interleukin-2 (IL-2) and interleukin-6 (IL-6) in the patients undergoing cardiac surgery under the condition of cardiopulmonary bypass (CPB). METHODS: Thirty patients undergoing valve replacement were randomly divided into control group (n=15) and UTI group (n=15). Blood samples were taken before operation and 4, 8, 24, 48, 168 h after operation for the determination of T-lymphocyte subpopulation (CD3, CD4, CD8, CD4/CD8), NK cell, IL-2 and IL-6. RESULTS: There was no significant difference in CD3, CD4, CD8, CD4/CD8, NK cell, IL-2 and IL-6 before operation between the 2 groups. The levels of CD3, CD4 and NK cells decreased at postoperative 4, 8, 24, 48 h in control group as compared with baseline value, and were lower than those in UTI group. Compared with control group , the level of CD3 in UTI group was higher at postoperative 8, 24, 48 h, and the level of CD4 was also higher at postoperative 4, 8, 24, 48 h, and the NK cells increased at postoperative 24, 48 h (P<0.05). Compared with baseline value, IL-2 level was lower at postoperative 4, 8, 24, 48 h in control group, while IL-6 increased significantly after operation (P<0.05); the tendency was the same in UTI group (P<0.05). The level of IL-2 in control group was lower than that in UTI group at postoperative 4, 8, 24, 48 h (P<0.05, P<0.01), while IL-6 in control group was remarkably higher than that in UTI group at postoperative 4, 8, 24, 48 h (P< 0.05). CONCLUSION: The depression of immunological function in CPB patients treated with UTI was less than that in the controls,which might be beneficial to the prognosis of the patients undergoing cardiac surgery.