心脏不停跳沐舒坦干预对肿瘤坏死因子的影响及临床意义

目的探讨心脏不停跳二尖瓣置换术中应用盐酸氨溴索(沐舒坦)对肺保护的效果。方法选择浅低温不停跳心脏瓣膜置换术患者30例,随机分为干预组(应用盐酸氨溴索)和对照组(不用盐酸氨溴索),每组15例。于CPB前(T1)、CPB40min(T2)、CPB结束即刻(T3)、CPB结束后1 h(T4)2、h(T5)、24 h(T6)抽取动脉血,测定血浆肿瘤坏死因子-α(TNF-α)。于T1、T2、T3、T4、T5、T6各时点行血气分析,计算呼吸指数RI。结果两组CPB期间TNF-α与CPB前比较均有不同程度升高,干预组与对照组TNF-α、RI,在CPB中各时点差异均有统计学意义(P<0.05)。结论TNF-α可作为CPB过程中检测肺保护效果的敏感指标;心脏不停跳二尖瓣置换术中应用盐酸氨溴索可抑制TNF-α形成,减轻CPB所致的炎性反应,具有较佳的肺保护效果。

Effect of mucosolvan on tumor necrosis factor in beating heart operation

Objective To study the lung protection of mucosolvan in beating heart mitral valve replacement.Methods 30 patients undertook beating heart mitral valve replacement were chosen.thery were divided into treatment group(treated with mucosolvan) and control group(without mucosolvan) randomly.15 cases in every group.they were let artetrial blood to measure the tumor necrosis factor α(TNF-α)and blood gas before CPB(T_1),CPB40min(T_2),the end of CPB(T_3)and 1 h(T_4),2 h(T_5),24 h(T_6)afterCPB.then their breathing index was accumulated.Results Two groups 'TNF-α during CPB were higher than before CPB.there were statistics significance of TNF-α、RI in every testing time(P<0.05).Conclusion TNF-α can be a sensitive stander of deciding the effect of lung protection during CPB.Mucosolvan can restrain the TNF-α in beating heart mitral valve replacement and decrease the inflammation of CPB.