腺苷预处理对瓣膜置换术患者PMN粘附分子CD11b表达及TNF-α、IL-6的影响

探讨腺苷预处理对体外循环 (CPB )瓣膜置换病人围术期炎性反应的影响。 32例心功能II～III级择期CPB瓣膜置换手术患者 ,随机分为腺苷预处理组和对照组 ,每组 1 6例 ,腺苷组于麻醉诱导后经颈内静脉泵入腺苷进行预处理。分别在术前、CPB前、CPB毕、术毕、术后 2 4h各时间点抽取桡动脉血以观察中性粒细胞粘附分子CD1 1b表达及炎性细胞因子TNF α、IL 6的水平。结果表明 ,术前及CPB前两组CD1 1b表达、TNF α及IL 6水平无明显差异 ,CPB毕、术毕、术后 2 4h时腺苷组各指标明显低于对照组 (P <0 0 5 ,P <0 0 1 )。与术前及CPB前相比 ,除IL 6 ,腺苷组中性粒细胞CD1 1b表达增加及TNF α和水平上升 ,但差异不明显 ;而对照组各指标明显升高 (P <0 0 5 ,P <0 0 1 )。可见腺苷预处理具有平抑体外循环下瓣膜置换术患者体内中性粒细胞粘附分子CD1 1b的表达及炎性细胞因子TNF α、IL 6的释放作用

Effect of Adenosine Pre-Conditioning on the Expression of CD11b on Neutrophils and the Plasma Levels of TNF-α and IL-6 in Patients Undergoing Valve Replace-ment During Cardiac Pulmonary Bypass

To investigate the effect of adenosine pre conditioning on pro inflammatory reactions induced by adenosine pre conditioning in patients undergoing valve replacement during cardiac pulmonary bypass in,32 cases scheduling for valve replacement were divided randomly into two groups:experiental and control groups,each with 16 cases and adenosine pre conditionings were to be performed in the experimental group before extracorporeal bypass Radial arterial blood was drawn before operation,before and after cardiac pulmonary bypass,at end of operation and 24 hours after operation to determine the CD11b integrin on neurophils and the plasma levels of TNF α and IL 6 The results showed that there were no significant differences in the expressions of neutrophil CD11b and the plasma levels of TNF α and IL 6 in the groups before operation and cardiac pulmonary bypass,but the values of the group with adenosine pre conditioning at end of cardiac pulmonary bypass,and operation,and 24 hours after operation were remarkablly lower than those of the control group Except for IL 6,the expressions of CD11b and the plasma levels of TNF α remained stable during the whole procedures of operation in the experimental group,but obviously increased in control group 24 hours after cardiac pulmonary bypass,at end of operation It concludes that adenosine pre conditioning could protect from injuries of myocardia ischemia reperfusion and affect the release of pro inflammatory cytokines