刘洪端 1刘立明 1曹亮 1谭昌明 1张昊 1潘彦宏1
作者信息
- 1. 中南大学湘雅二医院胸心外科,长沙410011
- 折叠
摘要
Abstract
Objective To investigate the protective effect of ischemic postconditioning against lung injury in combined mitral and aortic valve replacement, to compare the protective effects of different protocol of ischemic postconditioning, and to analyze its possible mechanisms. Methods 24 patients diagnosed as rheumatic mitral and aortic valve disease with or without tricuspid valve disease were randomized into 3 groups: control group, postconditioning group I and postconditioning group Ⅱ. The oxygenation index (OI) were measured at preoperation, 1h, 2h, 3h, 6h and 12h after terminating cardiopulmonary bypass (CPB). The plasma contents of TNF-α were detected by enzyme-linked immunosorbent assay at preoperation, lh, 3h, 6h and 12h after terminating CPB. Results Compared with control group and postconditioning group Ⅱ , OI in postconditioning group 1 significantly increased at 1h, 2h, 3h, 6h after terminating CPB (P<0.05); and the TNF-a contents in postconditioning group I reduced at lh, 3h, 6h, 12h after terminating CPB (P<0. 05). However, there was no significant difference between control group and the postconditioning group Ⅱ in OI and TNF-α contents. Conclusions Ischemic postconditioning by occlusion of the pulmonary artery of 5 cycles of 15s ischemia and 15s reperfusion attenuates the lung ischemic/reperfusion injury in combined mitral and aortic valve replacement, and is possibly mediated by inhibiting TNF-a expression. However, ischemic postconditioning by occlusion of the pulmonary artery of 5 cycles of 30s ischemia and 30s reperfusion does not show significant protective effect for lung ischemic reperfusion injury.关键词
缺血后处理/缺血再灌注损伤/肺/体外循环/心脏瓣膜假体植入/转化生长因子αKey words
ischemic postconditioning/ ischemic reperfusion injury/ lung/ extracorporeal circulation/heart valve prosthesis implantation/transforming growth factor alpha分类
医药卫生
