McBride W T, Armstrong M A, Gilliland H, McMurray T J
Department of Anaesthesia, Royal Victoria Hospital, Belfast.
Cytokine. 1996 Sep;8(9):724-9. doi: 10.1006/cyto.1996.0096.
During adult cardiac surgery the plasma pro-inflammatory cytokine response is balanced by a phased anti-inflammatory cytokine response. Whether a similar balanced plasma pro- and anti-inflammatory cytokine response occurred in paediatric cardiac surgery was investigated. Changes in intra-pulmonary cytokine balance by measuring bronchoalveolar lavage (BAL) cytokine content were also estimated. Plasma and BAL samples were obtained from 10 children (aged 15 months to 10 years) 10 min after induction of anaesthesia (sample 0), 5 min after the onset of cardiopulmonary bypass (CPB) (sample 1), 10 min after release of the aortic cross clamp (sample 2), and 2 and 24 h after the end of CPB (samples 3 and 4). BAL and plasma was assayed for interleukin 1 beta (IL-1 beta), tumour necrosis factor alpha (TNF-alpha), IL-8, IL-10, interleukin 1 receptor antagonist (IL-1ra) and the TNF soluble receptors (TNFsrs). There was a phased plasma anti-inflammatory response commencing with IL-10 (sample 2), and followed by significant increases in IL-1ra (samples 3, 4 and 5) and TNF soluble receptors (sample 5). Plasma TNF-alpha and IL-1 beta concentrations were not significantly elevated from baseline. Mean baseline plasma IL-8 was 30 (SEM 9) pg/ml. This was significantly elevated at sample 4 (112 (SEM 68) pg/ml). In BAL, only IL-8 and IL-10 were significantly elevated after CPB as compared with baseline. During paediatric cardiac surgery there is a significant increase in plasma and BAL IL-8. This is balanced within the plasma by a phased anti-inflammatory cytokine response, and within the lung by IL-10.
在成人心脏手术期间，血浆促炎细胞因子反应由阶段性抗炎细胞因子反应平衡。研究了小儿心脏手术中是否发生类似的血浆促炎和抗炎细胞因子反应平衡。还通过测量支气管肺泡灌洗（BAL）细胞因子含量评估了肺内细胞因子平衡的变化。在麻醉诱导后10分钟（样本0）、体外循环（CPB）开始后5分钟（样本1）、主动脉阻断钳松开后10分钟（样本2）以及CPB结束后2小时和24小时（样本3和4），从10名儿童（年龄15个月至10岁）获取血浆和BAL样本。对BAL和血浆检测白细胞介素1β（IL-1β）、肿瘤坏死因子α（TNF-α）、IL-8、IL-10、白细胞介素1受体拮抗剂（IL-1ra）和TNF可溶性受体（TNFsrs）。存在阶段性血浆抗炎反应，始于IL-10（样本2），随后IL-1ra（样本3、4和5）和TNF可溶性受体（样本5）显著增加。血浆TNF-α和IL-1β浓度未从基线显著升高。平均基线血浆IL-8为30（标准误9）pg/ml。在样本4时显著升高（112（标准误68）pg/ml）。在BAL中，与基线相比，CPB后仅IL-8和IL-10显著升高。在小儿心脏手术期间，血浆和BAL中的IL-8显著增加。这在血浆中由阶段性抗炎细胞因子反应平衡，在肺内由IL-10平衡。
