Musleh Ghassan S, Datta Subir S, Yonan Nizar N, Grotte Geir J, Prendergast Brian A, Hasan Ragheb I, Deyrania Abdul K
Manchester Royal Infirmary, Manchester, UK.
Eur J Cardiothorac Surg. 2009 Mar;35(3):511-4. doi: 10.1016/j.ejcts.2008.10.010. Epub 2008 Dec 11.
Assessment of the effects of haemofiltration during cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CABG) on the renal function and correlation with interleukin 6 (IL6) and interleukin 10 (IL10) levels.
Seventy-nine patients scheduled for elective CABG were prospectively randomised into two groups. Group A with a haemofilter attached to arterial line of the CPB circuit and group B without a haemofilter. The two groups were comparable in their symptoms, sex, and previous history of myocardial infarction, left ventricular function, cross-clamp time, bypass time and total grafting per patients. Blood urea and creatinine levels were measured the day before operation, 12h after operation and on the 3rd postoperative day. IL6 and IL10 were measured in blood samples collected 1h before surgery, on arrival to ITU and after 12h. IL6 and IL10 levels were measured using ELISA test.
High levels of IL6 (>100 pg/ml) postoperatively were associated with increased incidence of renal dysfunction (p<0.017). Additionally, high IL10 (>30 pg/ml) levels postoperatively were associated with increased incidence of renal dysfunction (p<0.014). There were no effects of the haemofilter on postoperative IL6 and IL10 levels. Use of haemofiltration during CPB was found not to be protective against renal dysfunction (p<0.071).
Haemofilter use during cardiopulmonary bypass does not have a protective effect on postoperative kidney function. Haemofilter has no effect on the level of IL6 and IL10.
评估冠状动脉搭桥术（CABG）体外循环（CPB）期间血液滤过对肾功能的影响及其与白细胞介素6（IL6）和白细胞介素10（IL10）水平的相关性。
79例择期行CABG的患者被前瞻性随机分为两组。A组在CPB回路动脉管路上连接血液滤过器，B组不使用血液滤过器。两组在症状、性别、既往心肌梗死病史、左心室功能、主动脉阻断时间、体外循环时间及每位患者的总移植血管数方面具有可比性。分别于术前1天、术后12小时及术后第3天测量血尿素和肌酐水平。在术前1小时、入重症监护病房时及术后12小时采集血样，检测IL6和IL10。采用酶联免疫吸附测定（ELISA）法检测IL6和IL10水平。
术后IL6水平高（>100 pg/ml）与肾功能障碍发生率增加相关（p<0.017）。此外，术后IL10水平高（>30 pg/ml）也与肾功能障碍发生率增加相关（p<0.014）。血液滤过器对术后IL6和IL10水平无影响。发现CPB期间使用血液滤过对肾功能障碍无保护作用（p<0.071）。
体外循环期间使用血液滤过器对术后肾功能无保护作用。血液滤过器对IL6和IL10水平无影响。
