乌司他丁对兔体外循环中细胞间黏附分子的影响

目的探讨体外循环(CPB)对肺内的细胞间粘附分子 1(ICAM 1)变化规律及乌司他丁干预性治疗效果。方法选取纯种新西兰大白兔2 0只,随机分为乌司他丁(UTI)组10例,CPB组10例。前者在体外循环预充液中加入1万U/kgUTI,CPB开始后再经静脉给1万U/kg。分别于麻醉诱导后、主肺动脉阻断前、主肺动脉开放前、主肺动脉开放3 0min、停CPB、停CPB后4h共6个时点抽取肺静脉血,采用双抗体夹心法酶联免疫吸附试验测定血浆中ICAM 1的表达值。结果麻醉诱导后(基值)乌司他丁组和CPB组ICAM 1无明显差异(P >0 0 5 ) ;余5个时点2组ICAM 1表达量均明显增高,主肺动脉开放后有一突发增长,停CPB后呈缓慢下降,但乌司他丁组5个时点ICAM 1表达值均低于对照组(P <0 0 5 )。结论体外循环过程中肺内皮细胞表面ICAM 1表达量在主肺动脉开放后有一突发增长,在停CPB后呈缓慢下降,乌司他丁能使内皮细胞上ICAM 1表达上调减缓,减少肺内活化中性粒细胞与内皮细胞的粘附,减轻CPB引起的脏器功能损伤,有效提高CPB下心脏直视手术的成功率。

EFFECT OF ULINASTATIN ON THE EXPRESSION OF ADHESION MOLECULES WITH CARDIOPULMONARY BYPASS IN RABBIT

Objective Cardiopulmonary bypass results in expression of adhesion molecules with pulmonary and the effect of Ulinastatin on lung function in CPB. Methods 20 New Zealand Rabbits were radamly divided into two groups. UTI 2 U/kg group (n=10), study group (n=10), Pulmonary vein Plasma level of ICAM-1 were assessed perioperatively. Results Before Cardiopulmonary Bypass, there is no significantly different between the two groups ,and the level of ICAM-1 is elevated to peak at the end of CPB but, the Ulinastatin group is significantly lower than the study group (P<0.05). Conclusion CPB cause the level of pulmonary vein plasma′s ICAM-1 increased and elevated to peak at the end of CPB then it slowly descends. Ulinastatin can notable slow down the expression of ICAM-1, alleviated the lung inflammatory response and has a lung protetive effect.