| 李顺洪 冯麟 李林佶 岳济民 何一娜.乌司他丁对心肺转流下心脏手术患者炎症因子及认知功能的影响[J].,2016,16(10):1930-1933 |
| 乌司他丁对心肺转流下心脏手术患者炎症因子及认知功能的影响 |
| Influence of Ulinastatin on Inflammatory Factors and Cognitive Function inPatients with Cardiac Surgery under Cardiopulmonary Bypass |
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| DOI： |
| 中文关键词: 乌司他丁 心肺转流 炎症因子 认知功能 |
| 英文关键词: Ulinastatin Cardiopulmonary bypass Inflammation factors Postoperative cognitive dysfunction |
| 基金项目: |
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| 中文摘要: |
| 目的：探索乌司他丁（UTI）对心肺转流（CPB）下心脏手术患者炎症因子及认知功能的影响。方法：选择自2010 年5 月至
2014 年9月我院收治的CPB 瓣膜置换手术患者60 例，按照随机数表法将患者分成对照组和观察组，每组30 例。观察组患者在
麻醉诱导后静脉泵入1.2× 104U/kg UTI，在CPB 结束前5 min 从体外管道内给予0.6× 104U/kg UTI，对照组患者给予等量的生理
盐水。对比两组CPB 前（T0）、CPB 开始后1 h（T1）、CPB结束后1 h（T2）、术后4 h（T3）及术后24 h（T4）的血浆肿瘤坏死因子-alpha
(TNF-alpha)、白细胞介素-6/10(IL-6/10)、中性粒细胞弹性蛋白酶(NE)、星形胶质细胞S100 蛋白的beta亚型(S100beta)、超氧化物歧化酶
(SOD)和丙二醛(MDA)，在术前1 d和术后7 d时，采用简易精神状态检查表(MMSE)对患者进行神经精神功能测试，并评价患者
的术后认知功能障碍(POCD)的发生率。结果：与T0 相比，两组患者T1-T4 的TNF-alpha、IL-6、NE、S100beta、MDA 水平明显升高，且观
察组显著低于对照组，而两组IL-10、SOD 水平显著下降，观察组显著高于对照组（P<0.05）。术后7d，两组患者MMSE 评分均明显
高于术前1 d，且观察组显著高于对照组（P<0.05）；观察组POCD 的发生率明显低于对照组（P<0.05）。结论：UTI 可以有效降低
CPB 下行瓣膜置换术患者的炎症因子水平，并改善患者的POCD，对于临床用药具有指导意义。 |
| 英文摘要: |
| Objective:To explore the influence of ulinastatin (UTI) on the inflammatory factors and cognitive function in patients
with cardiac surgery under cardiopulmonary bypass (CPB).Methods:A total of 60 patients, who underwent CPB valvular replacement
surgery in Nanchong Central Hospital of Sichuan Province fromMay 2010 to September 2014, were randomly divided into control group
(n=30) and observation group(n=30). The observation group was pumped into 1.2× 104U/kg UTI through vein after anesthesia induction,
and given 0.6 × 104U/kg UTI from vitro pipeline 5 min before the end of CPB, while the control group was given the same amount of
saline solution. The serumtumor necrosis factor-alpha(TNF-alpha),interleukin-6/10(IL-6/10), neutrophil elastase(NE), astrocytes S100 proteins beta
isoforms(S100beta), superoxide dismutase(SOD) and malondialdehyde(MDA) in the two groups before CPB(T0), 1 h before CPB(T1), 1h
after CPB(T2), 4 h after CPB(T3) and 24 h after CPB(T4) were compared respectively. The mini mental state examination(MMSE) The
nervous mental functions of the patients 1 d before surgery and 7 d after surgery were tested by the mini mental state examination
(MMSE); and the incidence of postoperative cognitive function (POCD) was evaluated.Results:Compared with the T0, the levels of
TNF-alpha, IL-6, NE, S100beta and MDA in the two groups at T1-T4 significantly increased, and the above indexes of the observation group
were significantly lower than those of the control group; meanwhile, the levels of IL-10 and SOD significantly decreased, but the above
indexes of the observation group were significantly higher than those of control group(P<0.05). MMSE scores in the two groups 7 d after
surgery were significantly higher than 1 d before surgery, in addition, the MMSE score of the observation group was significantly higher
than that of the control group (P<0.05). The incidence of POCD in the observation group was obviously lower than that in the control
group (P<0.05).Conclusion:UTI can effectively reduce the inflammatory factor levels of patients undergoing CPB valvular replacement
surgery, and improve the POCD status, which gives a guiding significance to clinical medication. |
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