体外循环心脏停跳或不停跳对血清IL-6、IL-8的影响

目的：探讨体外循环手术中心脏停跳或不停跳对血清IL－6、IL－8的影响。方法：20例先天性心脏间隔缺损病人，随机分成两组（n＝10）：A组在常规体外循环和心脏停跳情况下施行心脏间隔缺损修补手术，B组在体外循环心脏不停跳的情况下进行手术。每位病人在术前、体外循环开始、体外循环结束、术后第6，24和48h，桡动脉采血测定IL－6和IL－8。结果：（1）A组IL－6平均水平在体外循环开始后逐渐上升，在体外循环结束、术后第6，24及48h，均比体外循环开始前明显升高，术后6h达到高峰。与B组相比，A组患者在术后第6，24，48h的IL－6水平显著高于B组（P＜0．05，P＜0．01，P＜0．05）。A组患者IL－8在体外循环结束后迅速达到高峰（P＜0．01），术后24h恢复正常。与B组相比，体外循环结束及术后6hIL－8水平均显著增高（P＜0．01）。结论：在心外科手术中，体外循环引起病人血清IL－6和IL－8水平升高 ，心脏停跳方法将加重这种改变。建议尽可能地采用心脏不停跳和尽力缩短手术操作时间，减少术后的炎症反应和组织损伤。

Comparisons of the Effects of Cardiopulmonary Bypass with or without Cardiac Arrest on IL-6 and IL-8 Levels in Serum of Patients

Objective To compare the effects of cardiopulmonary bypass(CPB) with or without cardiac arrest on IL|6 and IL|8 levels in the serum of patients. Methods Twenty patients were randomly and equally divided into two groups: group A and group B. During the operation, group A was submitted to cardiac arrest, and group B without cardiac arrest. Blood samples were collected from the radial artery of each patient at six time points, i.e. preoperation, at the beginning of CPB, at the end of CPB and at the 6th, 24th and 48th hrs after operation, and the levels of IL|6 and IL|8 were measured. Results (1)The average IL|6 level in group A went up gradually after the initiation of CPB and increased significantly at the end of CPB and at the 6th, 24th and 48th hrs after operation; the peak value of IL|6 was at the 6th hrs after operation. In comparison with group B, the levels of IL|6 at the 6th, 24th and 48th hrs after operation were significantly higher(P<0 05,P<0 001,P<0 05) than those in group B. (2)The average level of IL|8 in group A rapidly reached to the peak at the end of CPB and returned to normal at the 24th hr after operation. The levels of IL|8 in group A at the end of CPB and at the 6th hr after operation were significantly higher(P<0 001) than those in group B. Conclusion In heart operations CPB could increase patients' serum IL|6 and IL|8 levels, and cardiac arrest aggravated those changes. Consequently, using beating heart opertion technique and reducing the duration of surgical manipulation as far as possible would be suggested, so as to reduce the body's inflammatory response and tissue damage.