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目的体外循环(CPB)前去除预充血液中的白细胞,探讨其对CPB肺保护作用。方法 50例≤10岁的室间隔缺损患儿随机分成实验组和对照组,实验组用去白细胞血预充,对照组用库存全血预充。测定围术期血浆中性粒细胞弹性蛋白酶(NE)、肿瘤坏死因子-α(TNF-α)、白介素(IL)-6、IL-8含量;氧合指数(OI)、肺泡-动脉血氧分压差(P(A-a)O2)及术后呼吸机通气时间。结果实验组CPB后血浆NE、TNF-α、IL-6和IL-8浓度及术后机械通气时间显著低于对照组(P<0.05,P<0.01),P(A-a)O2低于对照组(P<0.05)。OI在CPB后高于对照组(P<0.05)。结论去白细胞血预充能减少CPB后血中NE、TNF-α、IL-6和IL-8的含量,改善术后肺换气功能,具有良好的肺保护作用。
Objective To remove leukocytes from preconditioning blood before cardiopulmonary bypass (CPB) and investigate its protective effects on CPB. Methods Fifty children with ventricular septal defect ≤10 years old were randomly divided into experimental group and control group. The experimental group was pre-filled with leukocyte-depleted blood and the control group was pre-filled with whole-blood bank. Perioperative plasma neutrophil elastase (NE), tumor necrosis factor-α (TNF-α), interleukin (IL) -6 and IL-8 levels were measured; oxygenation index (OI), alveolar-arterial oxygen Partial pressure difference (P (Aa) O2) and ventilator ventilation time. Results The concentrations of NE, TNF-α, IL-6 and IL-8 in the experimental group were significantly lower than those in the control group after CPB (P <0.05, P <0.01) (P <0.05). OI in CPB after the control group (P <0.05). Conclusion Leukocyte preconditioning can reduce the content of NE, TNF-α, IL-6 and IL-8 in blood after CPB, and improve pulmonary ventilation function after CPB, which has a good lung protection effect.