乌司他丁对手术单肺通气期间白细胞介素-8的影响

[Effects of ulinastatin on interleukin-8 during one-lung ventilation in surgery].

作者信息

Li Wei, Wang Jian, Jiang Yan-Bo, Xu Mei-Xi

机构信息

Department of Anesthesiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, PR China.

出版信息

Ai Zheng. 2003 Oct;22(10):1074-6.

PMID:14558954

Abstract

BACKGROUND & OBJECTIVE: Ulinastatin is a kind of broad- spectrum hydrolase inhibitors purified from urine of healthy males.There was no data showing whether ulinastatin could affect alveolar inflammatory reactions.This study was designed to investigate the changes of pulmonary alveolar interleukin-8 during one lung ventilation (OLV) in surgery and the effects of ulinastatin on alveolar IL-8.

METHODS

Sixty patients,ASA II- III,who underwent lobectomy, were randomly divided into two groups [30 patients in each group,surgery group(II) and control group (I)].Patients in surgery group were treated with ulinastatin 5,000 u/kg preoperatively. Alveolar IL-8 was harvested by bronchoalveolar lavage at 0, 1, and 2 hours after one lung ventilation and at the end of surgery. The changes of concentration of IL-8 in bronchoalveolar lavage fluid were analyzed statistically.

RESULTS

(1)Alveolar interleukin 8 was significantly higher at 2 hours after OLV [(160.85+/-46.58)ng/L] than before OLV [(128.26+/-35.35)ng/L] in control group. The results indicated that OLV and/or the stimulation of surgery could induce the pulmonary inflammatory reaction. (2)The concentrations of alveolar IL-8 at 2 hours [(140.32+/-41.25)ng/L] after OLV and at the end of surgery [ (156.74+/-43.58) ng/L] were significantly lower in surgery group than those in control group [(160.85+/-46.58)ng/L and (172.41+/-52.60)ng/L] respectively(P< 0.05).

CONCLUSION

Ulinastatin could alleviate the pulmonary alveolar inflammatory reactions in OLV.

摘要

背景与目的

乌司他丁是从健康男性尿液中提取的一种广谱水解酶抑制剂。尚无数据表明乌司他丁是否会影响肺泡炎症反应。本研究旨在探讨手术单肺通气（OLV）期间肺泡白细胞介素-8的变化以及乌司他丁对肺泡白细胞介素-8的影响。

方法

60例拟行肺叶切除术的患者，美国麻醉医师协会（ASA）分级为Ⅱ-Ⅲ级，随机分为两组（每组30例）：手术组（Ⅱ组）和对照组（Ⅰ组）。手术组患者术前给予乌司他丁5000U/kg。在单肺通气后0、1、2小时及手术结束时，通过支气管肺泡灌洗收集肺泡白细胞介素-8。对支气管肺泡灌洗液中白细胞介素-8浓度的变化进行统计学分析。

结果

（1）对照组单肺通气后2小时肺泡白细胞介素-8[（160.85±46.58）ng/L]显著高于单肺通气前[（128.26±35.35）ng/L]。结果表明，单肺通气和/或手术刺激可诱发肺部炎症反应。（2）手术组单肺通气后2小时[（140.32±41.25）ng/L]及手术结束时[（156.74±43.58）ng/L]肺泡白细胞介素-8浓度显著低于对照组[分别为（160.85±46.58）ng/L和（172.41±52.60）ng/L]（P<0.05）。