异丙酚对体外循环下心脏瓣膜置换术患者血清白细胞介素-6及白细胞介素-10含量的影响

目的探讨体外循环过程中异丙酚对心脏瓣膜置换术患者血清白细胞介素（IL）-6及IL-10含量的影响。方法选择ASA Ⅲ级，预计主动脉阻断时间和体外循环时间分别在30、60min以上的风湿性心脏瓣膜病患者30例，随机分为对照组（C组）和异丙酚组（P组），每组15例。P组在中心静脉置管后以5mg／（kg·h）的速度输注异丙酚，分别于切皮前（T1）、主动脉阻断后30min（T2）、CPB停机后90min（T3）采集两组上腔静脉血检测血清IL-6和IL—10含量。结果两组IL-6含量在T2、T3均较T1升高（P〈0．05），并于T3达峰值，C组T3高于T2,差异有统计学意义（P〈0．05），P组T3与T2差异无统计学意义（P〉0．05）；两组IL-10在T2均较T1呈下降趋势，但仅C组T2与T1之间差异有统计学意义（P〈0．05），在T3均较T1、T2升高，两组T3与．T2比较差异均有统计学意义（P〈0．05）。两组患者血清IL-6、IL-10含量，在T1、T2差异均无统计学意义（P〉0．05），在T3时，P组IL-6高于C组，IL-10低于C组，差异均有统计学意义（P〈0．05）。结论心脏瓣膜置换术患者围术期使用异丙酚可以抑制IL-6的释放．促进IL-10的分泌．有效地抑制体外循环引起的炎性反应。

Effects of propofol on plasma concentration of IL - 6 and IL - 10 in patients undergoing valve replacement during cardiopulmonary bypass

Objective To explore the effects of propofol on plasma concentration of IL - 6 and IL- 10 in patients undergoing valve replacement during cardiopulmouary bypass （CPB）. Methods Thirty patients with rheumatic heart disease whose ASA scale were Ⅲ ,aortic clamping time and CPB time were estimated more than 30 and 60 minutes respectively were selected and randomly divided into two groups ： the control group （ group C, n = 15 ） and propofol group （ group P , n =15 ）. There were no differences between the two groups about medication during operation except that the propofol was used for anesthesia maintenance at the speed of 5 mg/（kg·h） in group P. Blood samples from superior vena cave were taken before operation （T1） , 30 min after aortic clamping （T2） , 90 min after discontinuation of CPB （T3） for detecting the plasma concentration of IL - 6 and IL - 10. Results The IL - 6 levels of the two groups at T2, T3 were higher than that at T1 （ P 〈 0.05） , and the level at T3 achieved crest value. The IL - 6 levels of group C at T3 were higher than T2 （ P 〈 0.05 ） , but there were no significant difference between T3 and T2 in group P. The IL - 10 levels of the two groups showed to descend at T2 and to step up at T3 , but there were significant difference only between T2 and T1 in group C （ P 〈 0.05） , while there were significant difference between T3 and T2 in the two groups（ P 〈 0.05）. The IL- 6 and IL - 10 levels of the two groups had no significant difference at T1 and T2, but at T3 the IL-6 levels in group P were higher than that in group C （ P 〈 0.05 ） , at the same time the IL - 10 levels in group P were low- er than that in group C （ P 〈 0.05 ）. Conclusions Propofol could inhibit inflammatory response by re- straining the release of IL -6 and promoting the secretion of IL - 10 during cardiopulmonary bypass.