還原型谷胱甘肽對體外循環期細胞因子IL-8和IL-6的影響

【摘要】 目的 觀察還原型谷胱甘肽對體外循環(CPB)期間白細胞介素8（IL8）和白細胞介素6(IL6)的影響。方法 選擇30例施行心臟手術患者，隨機分成實驗組和對照組(每組15例)。實驗組患者于手術開始時分別予還原型谷胱甘肽（35 mg/kg）溶于100 ml生理鹽水靜滴，對照組予生理鹽水靜滴。于CPB前(T1)、CPB 30 min(T2)、CPB停機(T3)、停機后2 h(T4)四個時點采血，采用放射免疫法測定兩組血清中IL8和IL6的濃度。結果 實驗組IL8、IL6血清濃度較對照組降低，差異有統計學意義(P＜0.05)。結論 還原型谷胱甘肽能減少CPB期間IL8和IL6的釋放，減輕全身炎性反應的程度。

【關鍵詞】 還原型谷胱甘肽;體外循環;炎性反應綜合征;白介素6;白介素8

文章編號：1003-1383(2010)02-0128-03 中圖分類號：R 654.1 文獻標識碼：A

doi:10.3969/j.issn.1003-1383.2010.02.005

The effects of GSH on Cytokines IL8，IL6 during cardiopulmonary bypass

ZHANG Weiwei，HUANG Haiqing

（Dept.of Anesthesiology，the First Affiliated Hospital of Guangxi Med.Coll.，Nanning， 530021）

【Abstract】 Objective To investigate the effects of glutathione (GSH) on interleukin8(IL8) and interleukin6(IL6) during cardiopulmonary bypass(CPB).

Methods Thirty patients undergoing Cardiac surgery were randomly divided into GSH group and control group(15 in each group).In GSH group，intravenous drip of 100 ml of GSH（35 mg/kg）was given at the beginning of surgery. Respectively，while the control group was given0.9% NaCl solution.Blood samples were taken before CPB，30min after CPB and 0h，2h after the end of CPB. The serum levels of IL8 and IL6 were measured by radioimmunoassay method in both groups.Results The serum levels of IL8 and IL6 in GSH group were significantly lower than that in control group(P＜0.05).Con

clusion The study shows that GSH could reduce the release of IL8，IL6 and inhibit systemic inflammatory response syndrome(SIRS) during CPB.

【Key words】 GSH；cardiopulmonary bypass；systemic inflammatory response syndrome； interleukin8；interleukin6

體外循環(cardiopulmonary bypass，CPB)是指應用人工管道將人體大血管與人工心肺機連接，從靜脈系統引出靜脈血，并在體外氧合，再經血泵將氧合血輸回動脈系統的全過程，又稱心肺轉流，主要應用于心臟、大血管手術。最近幾年，隨著CPB技術的不斷發展，心血管手術的安全性得到了很大提高。但是CPB后患者的器官損害仍是臨床方面面臨的一個重要問題。研究表明CPB后的器官損傷主要是由全身炎性反應綜合征(systemic inflammatory response syndrome，SIRS)引起。所以如何有效預防與控制CPB激發的SIRS，對減輕心臟手術后的器官損傷顯得尤為重要。谷胱甘肽是人類細胞中自然合成的一種肽，還原型谷胱甘肽（GSH）是主要的活性狀態，GSH含有的巰基（SH）是其發揮主要功能的基團，主要作用是消除自由基。對于還原型谷胱甘肽注射液能否減輕由CPB引起的SIRS，國內外報道不多。……