风湿性心脏病二尖瓣置换术中细胞因子水平的变化

目的测定风湿性心脏病二尖瓣置换术中细胞因子水平,了解它们的变化规律。方法 11例体外循环(CPB)下二尖瓣置换术患者,分别于术前,主动脉阻断前,主动脉阻断后5min,主动脉开放后10min、1h、2h、4h、24h测定白介素6(IL-6)、白介素8(IL-8)、白介素10(IL-10)以及肿瘤坏死因子(TNF)。结果IL-6、IL-8、IL-10水平在CPB开始后逐渐升高,在主动脉开放后2h左右达到高峰(P<0.01)。之后逐渐下降,到主动脉开放后24h已显著下降。TNF水平在CPB开始后逐渐升高,在主动脉开放后24h仍维持在很高的水平(P<0.01)。结论CPB下二尖瓣置换术中既有促炎因子水平的升高,又有抗炎因子的激活。

Changes of Plasma Cytokines in Mitral Valve Replacement for Rheumatic Heart Disease

OBJECTIVE To investigate the changes of plasma cytokines in patients undergoing mitral valve replacement for rheumatic heart disease. METHODS 11 patients undergoing mitral valve replacement(MVR) under cardiopul-monary bypass(CPB). We measure the plasma levels of IL -6,IL-8,IL - 10 and TNF by ELISA method. Serial venous blood samples were collected at the following intervals respectively; Pre - op, Before -aorta clamping, 5min after aortic cross - clamping and 1h,2h,4h,24h after aorta declamping. RESULTS The plasma levels of IL - 6, IL - 8 , IL - 10 and TNF gradually increased after the beginning of CPB. And IL - 6, IL - 8, IL - 10 reached the peak at 2h after aorta declamping( P <0. 01). TNF still maintains a high level at 24h after aorta declamping( P <0. 01) . CONCLUSION our study demonstrated that there were increases of plasma pro - inflammatory cytokines , but also elevation of plasma anti - inflammatory cytokine during mitral valve replacement under CPB.