Luo Wan-Jun, Ling Xiang, Huang Ri-Mao
Department of Cardiothoracic Surgery, Xiang Ya Hospital, Hunan Medical University, Changsha, Hunan 410008, China.
Eur J Cardiothorac Surg. 2004 May;25(5):766-71. doi: 10.1016/j.ejcts.2004.02.024.
This study is to evaluate the effects of aminophylline on systemic inflammatory response after cardiopulmonary bypass in patients undergoing valve replacement.
Thirty patients undergoing elective valve replacement were randomized to receive either aminophylline treatment (aminophylline, n = 15) or no aminophylline (control, n = 15). Administration of aminophylline (5 mg/kg) was injected intravenously after induction of anesthesia and maintained with 0.5 mg/kg per h until the end of cardiopulmonary bypass. Perioperative cytokines (interleukin-8 and interleukin-10, tumor necrosis factor-alpha) and respiratory function, blood neutrophil count ratio of right atrium to that of left atrium, plasma malondialdehyde were measured during the experiment.
Interleukin-8 and tumor necrosis factor-alpha levels after cardiopulmonary bypass were significantly lower in the aminophylline group than that in the control group (P < 0.05, for each group), and interleukin-10 level in aminophylline group was significantly higher than in control (P = 0.001). The respiratory index was greater in the control than in aminophylline group (P < 0.05). Neutrophil count ratio of right atrium blood to left atrium blood and plasma malondialdehyde level in aminophylline group were much lower (P = 0.02 and 0.001, respectively) than in the control 30 min after aortic declamping. Compared with control group, the duration of ventilation and intensive care unit stays were shorter in aminophylline group (P = 0.032 and 0.013, respectively).
Intraoperative administration of aminophylline had anti-inflammatory effect and improved pulmonary oxygenation in patients undergoing valve replacement.
本研究旨在评估氨茶碱对瓣膜置换术患者体外循环后全身炎症反应的影响。
30例行择期瓣膜置换术的患者被随机分为两组，分别接受氨茶碱治疗（氨茶碱组，n = 15）或不接受氨茶碱治疗（对照组，n = 15）。麻醉诱导后静脉注射氨茶碱（5 mg/kg），并以0.5 mg/kg每小时的速度持续输注直至体外循环结束。实验期间测量围手术期细胞因子（白细胞介素-8、白细胞介素-10、肿瘤坏死因子-α）、呼吸功能、右心房与左心房血液中性粒细胞计数比值、血浆丙二醛水平。
体外循环后，氨茶碱组白细胞介素-8和肿瘤坏死因子-α水平显著低于对照组（每组P < 0.05），氨茶碱组白细胞介素-10水平显著高于对照组（P = 0.001）。对照组呼吸指数高于氨茶碱组（P < 0.05）。主动脉开放30分钟后，氨茶碱组右心房与左心房血液中性粒细胞计数比值和血浆丙二醛水平均显著低于对照组（分别为P = 0.02和0.001）。与对照组相比，氨茶碱组通气时间和重症监护病房停留时间更短（分别为P = 0.032和0.013）。
术中给予氨茶碱对瓣膜置换术患者具有抗炎作用并改善肺氧合。
