米力农对体外循环心脏瓣膜置换术后患者细胞因子及左心室功能的影响

Effect of Milrinone on cytokines and left ventricular function in patients after valve replacement for cardiopulmonary bypass

摘要:

目的 探讨米力农对体外循环心脏瓣膜置换术后患者细胞因子及左心室功能的影响。方法 选取2011 年5 月-2015 年5 月于常州市第一人民医院收治的112 例行体外循环心脏瓣膜置换术患者，随机分为观察组和对照组，每组56 例。麻醉诱导前15 min，观察组给予50 μg/kg 米力农，对照组则以给予相同剂量的生理盐水。观察两组患者的血清细胞因子水平、呼吸功能及心功能。结果 观察组的肿瘤坏死因子α（TNF-α）、白介素6（IL-6）及白介素8（IL-8）水平在对应的时间均低于对照组（P <0.05），而白介素10（IL-10）水平在对应的时间均高于对照组（P <0.05）。观察组患者呼吸功能指标均低于对照组（P <0.05）。给药后两组患者的心功能指标均较给药前差异有统计学意义（P <0.05），且观察组变化幅度更大。结论 米力农能调节体外循环心脏瓣膜置换术后患者的细胞因子水平，能改善左心室功能和保护肺脏功能，值得临床推广应用。

Abstract:

Objective To investigate the effect of Milrinone on cytokines and left ventricular function in patients after valve replacement for cardiopulmonary bypass. Methods A total of 112 patients given valve replacement for cardiopulmonary bypass in our hospital from May 2011 to May 2015 were divided into control group and observation group (56 cases for each group). The observation group was given 50 μg/kg Milrinone 15 min before induction of anesthesia, and the control group was given the same dose of normal saline. The serum cytokine levels, respiratory function and cardiac function were observed and compared. Results TNF-α, IL-6 and IL-8 levels in the observation group were lower than those in the control group (P < 0.05), while the IL-10 level was higher than that in the control group (P < 0.05). The respiratory function indexes of the observation group were lower than those of the control group (P < 0.05). The heart function indexes of the two groups were significantly different after administration than before, and the change range of the observation group was greater. Conclusion Milrinone can significantly modulate cytokine levels in patients after valve replacement for cardiopulmonary bypass, improve left ventricular function and protect lung function, which is worthy of clinical application.