儿童体外循环围术期支气管肺泡灌洗液中IL-8的变化及意义

目的探讨体外循环和肺动脉高压对肺局部IL-8的影响,为临床诊疗寻找监测气道高反应的有价值的分子生物学指标。方法对34例心脏直视手术,20例普胸部手术患儿分别于麻醉插管后手术前、手术后2~3h、手术后24h共3个时点采集肺泡灌洗液,采用双抗体夹心酶联免疫吸附(ELISA)法检测患儿IL-8的变化。结果术前IL-8体外循环组和非体外循环组无差异,但术后2~3h、24h体外循环组高于非体外循环组;各时点IL-8水本肺高压组均高于无肺高压组,同时肺动脉高压患儿术后出现气道高反应的比例(6/9)高于其他无肺动脉高压患儿(5/25)。结论体外循环使肺泡灌洗液IL-8水平升高,可能与体外循环术后的气道反应性增高有关;合并肺动脉高压的左向右分流患者IL-8水平高于无肺动脉高压组,术后容易出现呼吸道并发症,易致高反应发生。

Variations and Significance of IL-8 in the Bronchoalveolar Lavage Fluid in the Perioperative Period of Cardiopulmonary Bypass Operation on Children

Objective To understand the influence of cardiopulmonary bypass(CPB) and pulmonary hypertension(PH) on IL-8 in lung,and find valuable and sensitive molecular biomarkers for monitoring airway hyperresponsiveness(AHR) in clinical diagnosis and treatment.Methods The bronchoalveolar lavage fluid(BLAF) samples were taken at three different time points(preoperative,2-3 and 24 hours postoperative respectively) from CPB group(34 cases) and Non-CPB group(20 cases).The expressions of IL-8 in the two groups were measured by sandwich enzyme-linked immunosorbent assay(ELISA).Results There was no difference between the two groups on preoperative expression of IL-8,while 2-3 and 24 hours postoperative expressions of IL-8 in CPB group were significantly higher than those in NonCPB group.The expressions of IL-8 in PH group(9 cases) were higher than those in Non-PH group(25 cases) at all three time points,and the ratio of postoperative AHR in children with PH(6/9) was higher than that without PH(5/25).Conclusions The ascent of IL-8 level in BLAF caused by CPB may be associated with increasing airway responsiveness after CPB.PH patients combine with the left-to-right shunt,of which IL-8 levels are higher than those without PH,are subject to pulmonary complications and AHR.