乌司他丁对食管癌围术期肺炎性反应的影响

目的 探讨乌司他丁对食管癌手术所致肺炎性反应的影响.方法 选择40例限期行食管癌根治术患者,随机分为对照组(n=20)和乌司他丁组(n=20).乌司他丁组按5000 U/kg给予乌司他丁,对照组以等量生理盐水代替.于手术前(T1),术中恢复双肺通气后10 min(T2)、24 h(T3)、48 h(T4)各监测时点抽取静脉血3 ml,并于T1和T2时点收集支气管肺泡灌洗液3 ml.用ELISA法测定血浆及支气管肺泡灌洗液中IL-6、IL-8的浓度.结果 两组患者T2、T3、T4时点的血浆及T2时点的支气管肺泡灌洗液中IL-6及IL-8浓度均升高,与术前比较差异有显著性(P＜0.01).乌司他丁组IL-6、IL-8增高幅度较C组小,两组比较有统计学差异(P＜0.05).结论 食管癌手术存在炎性反应,乌司他丁可抑制血浆及支气管肺泡灌洗液中IL-6及IL-8浓度.

Effect of ulinastatin on inflammatory responses induced by oesophagectomy

OBJECTIVE: To examine the effect of ulinastatin (UTI) on the inflammatory responses induced by oesophagectomy. METHODS: Forty patients with esophageal cancer (without serious hypertension, heart disease, or respiratory function impairment, including 34 men and 6 women aged 46 to 70 years) scheduled for oesophagectomy via left thoracotomy were randomly divided into control group (n=20) and UTI group (n=20). Anesthesia induction and perioperative management followed the same protocols in the two groups, and in UTI group, patients received 5000 U/kg UTI while those in the control group were given the same volume of saline. Before operation (T(1)), 10 min after recovery of two-lung ventilation (T(2)), and 24 h (T(3)) and 48 h (T(4)) after operation, the venous blood sample was taken from the internal jugular vein and the plasma was separated and stored at -70 degrees C for later analysis of IL-6 and IL-8 with enzyme-linked immunosorbent assay (ELISA). The bronchoalveoar lavage fluid (BAFL) was also collected at T(1) and T(2) for IL-6 and IL-8 detection. RESULTS: IL-6, IL-8 levels in the plasma and BALF collected at T(2)-T(4) increased significantly as compared with those in samples collected at T(1), and their peak concentration inplasma and BALF samples were similar. IL-6 and IL-8 levels in the UTI group were significantly lower than those in the control group during the time points of T(2)-T(4). CONCLUSION: Inflammatory responses occur during and after oesophagectomy, which can be inhibited with UTI.