Pan Shan, Lin Guoqiang, Jiang Haihe, Huang Rimao
Department of Thoracic Surgery, Fuzhou Pulmonary Hospital, Fuzhou Fujian 350000,China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2009 Nov;34(11):1126-31.
To investigate the protective effect of aminophylline on cerebral injury induced by cardiopulmonary bypass (CPB) in infants.
Forty patients who underwent ventricular septal defect within 3 years old were randomly divided into 2 groups(20 cases in each group).Aminophylline group:aminophylline (5 mg/kg) was injected slowly via the vein after anesthesia and maintained at a dose of 0.5 mg/(kg.h) until the end of CPB.
aminophylline was replaced by Ringer's lactated solution. Samples were obtained at the beginning of CPB (T(1)),the end of CPB (T(2)),6 h (T(3)) and 24 h (T(4)) after the operation to measure S-100 beta protein, NSE, tumor necrosis factor-alpha (TNF-alpha), interleukin-8 (IL-8), and interleukin-10 (IL-10) concentration by ELISA in the 2 groups.
Compared with the time point immediately before CPB, the S-100beta protein,NSE, TNF-alpha, and IL-8 concentration in the 2 groups began to increase with the start of CPB, reached a climax at the end of CPB (T(2)),decreased gradually 6 h after the termination of CPB(T(3)) and could not restore to the level before CPB at T(4)(24 h after the termination of CPB).IL-10 in the 2 groups both increased after the CPB. At T(2) and T(3), S-100beta protein,NSE, TNF-alpha, and IL-8 concentrations were significantly lower than those in the aminophylline group (P<0.05 or P<0.01), while IL-10 was just the opposite.
There is cerebral damage induced by CPB. Aminophylline may play a protective role in cerebral injury by modulating the balance between the pro-inflammatory factor and anti-inflammatory factor to reduce the level of S-100beta protein and NSE during CPB and open cardiac surgeries.
探讨氨茶碱对婴儿体外循环（CPB）所致脑损伤的保护作用。
将40例3岁以内行室间隔缺损修补术的患儿随机分为2组（每组20例）。氨茶碱组：麻醉后静脉缓慢注射氨茶碱（5mg/kg），并以0.5mg/（kg·h）的剂量维持至CPB结束。
用乳酸林格液代替氨茶碱。分别于CPB开始时（T1）、CPB结束时（T2）、术后6h（T3）和24h（T4）采集两组样本，采用酶联免疫吸附测定法（ELISA）检测S-100β蛋白、神经元特异性烯醇化酶（NSE）、肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）和白细胞介素-10（IL-10）的浓度。
与CPB前即刻相比，两组S-100β蛋白、NSE、TNF-α和IL-8浓度在CPB开始时均开始升高，在CPB结束时（T2）达到高峰，CPB结束后6h（T3）逐渐下降，在CPB结束后24h（T4）仍未恢复至CPB前水平。两组IL-10在CPB后均升高。在T2和T3时，对照组S-100β蛋白、NSE、TNF-α和IL-8浓度均显著低于氨茶碱组（P<0.05或P<0.01），而IL-10则相反。
CPB可导致脑损伤。氨茶碱可能通过调节促炎因子与抗炎因子之间的平衡，在CPB及心脏直视手术期间降低S-100β蛋白和NSE水平，从而对脑损伤起到保护作用。
