乌司他丁在体外循环中肺保护机制的研究.doc

乌司他丁在体外循环中肺保护机制的研究 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：乌司他丁在体外循环中肺保护机制的研究 1 1 资料与方法 2 2 结 果 3 3 讨 论 4 文2：乌司他丁在体外循环心脏手术中对细胞免疫功能的影响 6 参考文摘引言： 12 原创性声明（模板） 13 文章致谢（模板） 13 正文 乌司他丁在体外循环中肺保护机制的研究 文1：乌司他丁在体外循环中肺保护机制的研究 Abstract: OBJECTIVE To evaluate the protection of Ulinastatin (UTI) on pulmonary tissue during cardiopulmonary bypass(CPB). METHODS 25 patients undergoing open-heart surgery with CPB were evaluated in this study. The patients were randomly divided into two groups:　control group and experimental group. The experimental group received UTI as the way of pulmonary protection. Polymorphonuclear neutrophils (PMN) and platelet (Plt) count, interleukin-6(IL-6), IL-10, tumor necrosis factor-α(TNF-α), lung compliance and the histological examination under electron microscopy of the lung were recorded perioperatively. RESULTS The changes of PMN and Plt count in the right atrium blood were significantly higher than that in the left one after aorta declamp off in control group(P). The plasma levels of IL-6 and TNF-α in experimental group were significantly lower than that of the control group (P) . IL-10 in experimental group increased compared with control group (P). Lung compliance decreased significantly in control group. The histological examination of the lung confirmed that the degree of lung injury was significantly decreased in experimental group. CONCLUSION Our results demotrated that the Ulinastatin could protect pulmonary tissue during CPB. Key words： Ulinastatin；Cardiopulmonary bypass；Pulmonary protect；Lung injury 体外循环（cardiopulmonary bypass，CPB）诱发全身炎症反应（systemic inflammatory respoe, SIR）的观点逐渐被人们接受，而肺的炎症反应是SIR在肺脏局部的表现。笔者对25例CPB的患者应用了乌司他丁（尿胰蛋白酶抑制剂，UTI），研究CPB的肺损伤以及UTI肺保护作用的可能机制，从而为CPB肺保护提供新的途径和方法。 1 资料与方法 临床资料 随机选择南京医科大学第一附属 医院 CPB患者25例，分为实验组（n=13）和对照组（n=12），所有患者均无肺、肝、肾和凝血功能障碍，术前一周内未使用影响凝血功能的药物。术前均向患者及家属交代，并签署知情同意书。患者情况见表1。 方法 麻醉和CPB方法 两组患者其麻醉、手术步骤相同。使用美国产Sar 8000型人工心肺机和鼓泡式氧合器，中度低温（24℃～32℃），中度血液稀释（Hct ～），非搏动性体外灌注，流量50～100 ml/（kg·min