Hill G E, Snider S, Galbraith T A, Forst S, Robbins R A
Department of Anesthesiology, University of Nebraska Medical Center, Omaha, USA.
Am J Respir Crit Care Med. 1995 Dec;152(6 Pt 1):1791-5. doi: 10.1164/ajrccm.152.6.8520738.
Tumor necrosis factor-alpha (TNF-alpha) is released in inflammatory lung conditions, raising airway nitric oxide (NO) concentrations through the cytokine-mediated induction of nitric oxide synthase (NOS). Cardiopulmonary bypass (CPB) creates an inflammatory state, characterized by the release of TNF-alpha, that may result in lung injury following CPB. This study measured plasma levels of TNF-alpha and interleukin-6 (IL-6) as well as airway NO concentrations during CPB, and the effect of methylprednisolone (MPSS) on the levels of these inflammatory products. Twenty adult males scheduled for coronary artery bypass grafting (CABG) were anesthetized and randomized to a group given MPSS at 1 gm intravenously 5 min before CPB (Group S) or a group not given MPSS (Group N). Plasma levels of TNF-alpha and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) and the airway NO concentration by chemiluminescence. TNF-alpha was significantly (p < 0.05) increased at 30 min after the termination of CPB, while IL-6 was significantly (p < 0.05) increased at 50 min into CPB and 30 min after the end of CPB in Group N as compared with controls in the same group and with Group S at the same time intervals. A group of 10 patients undergoing repair of infrarenal aortic aneurysms, which served as a control group for plasma levels of TNF-alpha, showed no significant changes in TNF-alpha concentrations at any time during aneurysm repair. Airway NO increased significantly (p < 0.01) in Group N as compared with Group S at 5, 20, 35, and 50 min of CPB.(ABSTRACT TRUNCATED AT 250 WORDS)
肿瘤坏死因子-α（TNF-α）在肺部炎症状态下释放，通过细胞因子介导诱导一氧化氮合酶（NOS）增加气道一氧化氮（NO）浓度。体外循环（CPB）会引发炎症状态，其特征是TNF-α的释放，这可能导致CPB后肺损伤。本研究测量了CPB期间血浆TNF-α和白细胞介素-6（IL-6）水平以及气道NO浓度，以及甲泼尼龙（MPSS）对这些炎症产物水平的影响。20名计划进行冠状动脉旁路移植术（CABG）的成年男性接受麻醉，并随机分为两组，一组在CPB前5分钟静脉注射1克MPSS（S组），另一组不给予MPSS（N组）。通过酶联免疫吸附测定（ELISA）测量血浆TNF-α和IL-6水平，通过化学发光法测量气道NO浓度。与同一组的对照组以及相同时间间隔的S组相比，N组在CPB结束后30分钟时TNF-α显著升高（p < 0.05），而IL-6在CPB开始50分钟时以及CPB结束后30分钟时显著升高（p < 0.05）。一组10名接受肾下腹主动脉瘤修复的患者作为血浆TNF-α水平的对照组，在动脉瘤修复期间任何时间TNF-α浓度均无显著变化。与S组相比，N组在CPB的5、20、35和50分钟时气道NO显著升高（p < 0.01）。（摘要截短至250字）
