实用医学杂志2026，Vol.42Issue(9)：1642-1648,7.DOI:10.3969/j.issn.1006-5725.2026.09.020
西维来司他钠对儿童先天性心脏病体外循环术后肺损伤及炎症反应的影响
Effects of sivelestat sodium on lung injury and inflammatory response after cardiopulmonary bypass in pe-diatric patients with congenital heart disease
摘要
Abstract
Objective To evaluate the efficacy of Sivelestat Sodium in mitigating pulmonary injury and inflammatory responses in pediatric patients with congenital heart disease(CHD)following cardiopulmonary bypass(CPB)-assisted open-heart surgery.Methods This randomized controlled trial enrolled 100 children undergoing CPB-assisted CHD surgery at the Department of Pediatric Critical Care Medicine,Guizhou Hospital of Shanghai Children's Medical Center from January to June 2024.Patients were randomly assigned to receive either Sivelestat Sodium(treatment group,n=50)or normal saline(control group,n=50).Baseline characteristics,inflammatory biomarkers,and cardiopulmonary function parameters were dynamically assessed at 0,24,and 72 hours postoperatively.Results No statistically significant differences were observed between the two groups regarding baseline characteristics,clinical parameters,inflammatory markers,or cardiopulmonary function at 0 and 24 hours postoperatively.Compared with the control group,at 72 hours postoperatively,the treatment group exhibited significantly lower values in the following parameters:lung ultrasound score[5.0(4.0,6.0)vs.7(5.5,8.5),P＜0.05],white blood cell count[8.8(7.8,11.1)×109/L vs.11.1(9.7,12.0)×109/L,P＜0.05],neutrophil count[5.4(4.1,8.6)×109/Lvs.7.3(6.2,9.9)×109/L,P＜0.05],interleukin-6[35.2(28.4,45.6)pg/mL vs.52.8(41.3,68.9)pg/mL,P＜0.05],C-reactive protein[21(12,38)mg/L vs.32(18,40)mg/L,P＜0.05],procalcitonin[1.46(0.60,2.29)ng/mL vs.2.51(1.80,3.64)ng/mL,P＜0.05],and tumor necrosis factor-α[9.3(6.4,12.3)pg/mL vs.11.7(9.7,16.0)pg/mL,P＜0.05].The PaO2/FiO2 ratio was significantly higher in the treatment group at 72 hours postoperatively[404(353,553)mmHg vs.355(300,417)mmHg,P＜0.05].No statistically significant differences were found between groups at 72 hours for interleukin-10,left ventricular ejection fraction,velocity time integral,or N-terminal pro-B-type natriuretic peptide.Regarding clinical outcomes,the duration of invasive mechanical ventilation was significantly shorter in the treatment group compared with the control group(P=0.019).Conclusion Sivelestat Sodium effectively attenuates postoperative pulmonary dysfunction in children with CHD undergoing CPB-assisted surgery by suppressing neutrophil-mediated inflammatory cascades,resulting in reduced ventilator dependence and improved early recovery.关键词
西维来司他钠/急性肺损伤/先天性心脏病/体外循环/炎症反应Key words
sivelestat sodium/acute lung injury/congenital heart disease/cardiopulmonary bypass/inflammatory response分类
医药卫生引用本文复制引用
刘禹江,刘玉洁,喻玢,徐树红,杨覃粤,黄栋..西维来司他钠对儿童先天性心脏病体外循环术后肺损伤及炎症反应的影响[J].实用医学杂志,2026,42(9):1642-1648,7.基金项目
国家自然科学青年基金项目(编号:82400364) （编号:82400364）
贵州省卫生健康委员会科学技术基金项目(编号:gzwkj2025-084) （编号:gzwkj2025-084）
