盐酸戊乙奎醚对体外循环心脏手术患者肺功能的影响费.pdf

!500!湖北医药学院学报(JHBUM)2010年12月,29(6):500

盐酸戊乙奎醚对体外循环心脏手术患者肺功能的影响

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余开峰,潘雪莲,李颖波
(湖北医药学院附属人民医院麻醉科,湖北十堰442000)

[摘要]目的:探讨盐酸戊乙奎醚对体外循环(CPB)下心脏手术患者肺功能的影响及可能机制。方法:24例
CPB心脏手术患者随机分为对照组和盐酸戊乙奎醚组,于体外循环开始前30min,分别注射0.9%氯化钠溶液5

mL,和盐酸戊乙奎醚0.02mg/kg。CPB前(T1)、主动脉开放后30min(T2),CPB结束后4h(T3)、CPB后24h(T4)
进行血气分析及检测血浆肿瘤坏死因子(TNF)和白细胞介素6(IL6)水平,计算肺泡-动脉血氧分压差[P(A

a)DO2]和呼吸指数(RI)。结果:2组患者T2、T3、T4时点与T1时点相比,P(Aa)DO2、RI及血浆TNF和IL6浓

度均显著升高(P<0.05);盐酸戊乙奎醚组T2、T3、T4时点P(Aa)DO2和RI,及TNF和IL6浓度较对照组均显
著降低(P<0.05)。结论:盐酸戊乙奎醚对体外循环下心脏手术患者肺功能有一定的保护作用,其机制可能与其抑
制TNF和IL6有关。

[关键词]盐酸戊乙奎醚;体外循环;呼吸指数;P(Aa)DO2;TNF;IL6
[中图法分类号]R614.4[文献标识码]A[文章编号]1006-9674(2010)06-0500-03

EffectsofPenehyclidineHydrochlorideonLungFunctioninPatientsUndergoingCardiacSurgerywithCardiopul
monaryBypassYUKaifeng,PANXuelian,LIYingbo*(DepartmentofAnesthesiology,RenminHospital,HubeiU
niversityofMedicine,Shiyan,Hubei442000,China)
Abstract:ObjectiveTostudytheeffectsofpenehyclidinehydrochlorideonlungfuctioninpatientsundergoingcardiacsur
gerywithcardiopulmonarybypass(CPB)anditspossiblemechanism.MethodsTwentyfourcardiacsurgicalpatientswere
randomlydividedintocontrolgroup(groupC,n=12)andpenehyclidinehydrochloridegroup(groupP,n=12).Penehyclid
inehydrochloride(0.02mg/kg)wasintravenouslyinjectedat30minbeforeCPBingroupP,meanwhile5mLphysiological
salinewasinjectedingroupC.TheconcentrationofTNFandIL6inplasmawasmeasuredandbloodgasanalysiswas

performedatpreCPB(T1),30minafteraortaopening(T2)and4h(T3)and24h(T4)afterCPB,andthealveolararterial

oxygenpressuredifference[P(Aa)DO2]andrespiratoryindex(RI)wasmeasuredwitharterybloodgasanalysis.ResultsP

(Aa)DO2,RI,TNFandIL6constrationsinplasmaintwogroupsatT2,T3andT4weresignificantlyincreasedcompared

withthoseatT1(P<0.05);theabovementionedindexesatT2,T3andT4ingroupPwereallsignificantlylowerthanthose
ofgroupC(P<0.05).ConclusionPenehyclidinehydrochloridecouldprotectthelungfunctionofpatientsundergoingcar
diacsurgerywithCPBthroughinhibitingsecretionofTNFandIL6.

Keywords:Penehyclidinehydrochloride;Cardiopulmonarybypass;R