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心脏手术后的肺部炎症反应综合征及氯诺昔康的治疗

Lung inflammatory response syndrome after cardiac-operations and treatment of lornoxicam.

作者信息

Tsakiridis Kosmas, Mpakas Andreas, Kesisis George, Arikas Stamatis, Argyriou Michael, Siminelakis Stavros, Zarogoulidis Paul, Katsikogiannis Nikolaos, Kougioumtzi Ioanna, Tsiouda Theodora, Sarika Eirini, Katamoutou Ioanna, Zarogoulidis Konstantinos

机构信息

1 Cardiothoracic Surgery Department, 2 Oncology Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 3 Cardiac Surgery Department, Evaggelismos General Hospital, Veikou 9-11, 11146 Athens, Greece ; 4 Department of Cardiac Surgery, University of Ioannina, School of Medicine, Greece ; 5 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 6 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Internal Medicine Department, "Theiageneio" Anticancer Hospital, Thessaloniki, Greece.

出版信息

J Thorac Dis. 2014 Mar;6 Suppl 1(Suppl 1):S78-98. doi: 10.3978/j.issn.2072-1439.2013.12.07.

Abstract

The majority of patients survive after extracorporeal circulation without any clinically apparent deleterious effects. However, disturbances exist in various degrees sometimes, which indicate the harmful effects of cardiopulmonary bypass (CPB) in the body. Several factors during extracorporeal circulation either mechanical dependent (exposure of blood to non-biological area) or mechanical independent (surgical wounds, ischemia and reperfusion, alteration in body temperature, release of endotoxins) have been shown to trigger the inflammatory reaction of the body. The complement activation, the release of cytokines, the leukocyte activation and accumulation as well as the production of several "mediators" such as oxygen free radicals, metabolites of arachidonic acid, platelet activating factors (PAF), nitric acid, and endothelin. The investigation continues today on the three metabolites of lornoxicam (the hydroxylated metabolite and two other metabolites of unknown chemical composition) to search for potential new pharmacological properties and activities.

摘要

大多数患者在体外循环后存活,且无任何临床上明显的有害影响。然而,有时会存在不同程度的紊乱,这表明体外循环(CPB)对身体有有害影响。体外循环期间的几个因素,要么是机械依赖性的(血液暴露于非生物区域),要么是机械非依赖性的(手术伤口、缺血和再灌注、体温变化、内毒素释放),已被证明会引发身体的炎症反应。包括补体激活、细胞因子释放、白细胞激活和聚集,以及几种“介质”的产生,如氧自由基、花生四烯酸代谢产物、血小板活化因子(PAF)、一氧化氮和内皮素。如今,对氯诺昔康的三种代谢产物(羟基化代谢产物和另外两种化学成分未知的代谢产物)的研究仍在继续,以寻找潜在的新药理学特性和活性。

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