文章摘要
赵 飞,陈 亮,甄福喜.前列腺素E1在体外循环中调控炎症反应及肺保护作用的研究[J].南京医科大学学报,2007,(8):864~866874
前列腺素E1在体外循环中调控炎症反应及肺保护作用的研究
The protective effect of prostaglandin E1 on lungs during cardiopulmonary bypass
投稿时间:2007-01-15  
DOI:10.7655
中文关键词: 前列腺素E1  炎症反应  体外循环  肺保护
英文关键词: prostaglandin E1  inflammatory system  cardiopulmonary bypass  lung protection
基金项目:
作者单位
赵 飞 南京医科大学第一附属医院胸心外科,江苏 南京 210029 
陈 亮  
甄福喜  
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中文摘要:
      目的:研究前列腺素E1(PGE1)调控炎症系统对体外循环(CPB)中肺损伤的保护作用?方法:选取2006年3月至6月24例风湿性心脏瓣膜病手术患者,随机分为对照组和实验组(PGE1 治疗组),各12例?实验组于麻醉诱导时从中心静脉泵入PGE1[15 ng/(kg·min)]至CPB结束?于转流前5 min?心脏复跳后15 min检测左?右心房血中性粒细胞(PMN)及血小板(Plt)计数?检测转流前5 min(T1)?转流30 min(T2)?心脏复跳后15 min(T3)?CPB结束1 h(T4)和6 h(T5)的血清sE-选择素?C反应蛋白(CRP)浓度?记录麻醉诱导后?开胸后?CPB及手术结束时的肺顺应性(CL)及氧合指数(OI)?结果:①两组转流前左?右心房血PMN?Plt无显著差异,心脏复跳后15 min对照组左心房血PMN?Plt明显低于右心房血(P < 0.01),实验组左?右心房血PMN?Plt计数无显著差异(P > 0.05);②CPB开始后两组sE-选择素的浓度逐渐升高,对照组更为明显(P < 0.01);③CPB开始后实验组CRP浓度较对照组明显降低(P < 0.01);④CPB结束时,实验组氧合指数(oxygenation index,OI)显著低于对照组(P < 0.01),肺顺应性(compliance of lung,CL)显著高于对照组(P < 0.01)?结论:PGE1可减轻CPB引起的PNM及Plt在肺内聚集?抑制血管内皮细胞的激活,减轻血管内皮细胞损伤,减少全身炎症反应,并减轻由此引起的肺损伤?
英文摘要:
      Objective:To investigate the protective effects of prostaglandin E1(PGE1) on lung injury by regulating inflammatory system during cardiopulmonary bypass(CPB). Methods:From March to June in 2006,a total of 24 patients undergoing cardiac surgery were randomly divided into the control group(n = 12) and the experimental group(n = 12). Each patient in the experimental group received 15 ng(kg·min). min-1 of PGE1 from the induction of anaesthesia to the end of CPB. Blood PMN and Plt in left and right atrium were measured at 5 min before CPB and 15 min after heart resuscitation. The levels of sE-selectin and CRP in serum were measured at 5 min before CPB,30 min on CPB,15 min after heart resuscitation,1 h and 6 h after CPB. Oxygenation index(OI)and compliance of lung(CL) were also recorded in both groups. Results:①PMN and Plt count in the blood in left atrium were significantly lower than that in right atrium at 15 min after heart resuscitation in the control group(P < 0.01). ②During and after CPB,the level of sE-selectin increased in both groups, but it was significantly higher in the control group than that in the experimental group(P < 0.01). ③During and after CPB, the level of CRP in the experimental group was significantly lower than that in the control group(P < 0.01).④Compared with the control group, OI was significantly lower(P < 0.01) and CL was significantly higher in the experimental group(P < 0.01) at the end of CPB. Conclusion:PGE1 can effectively reduce the sequestration of neutrophil and platelet in the lungs,inhibit the activation of vascular endothelial cells and protect lungs during CPB.
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