合并糖尿病的老年患者单肺通气时血清及肺泡灌洗液中炎性因子的变化及乌司他丁的干预效应

发布时间：2018-04-11 12:44

本文选题：型糖尿病 + 单肺通气　；参考：《中国老年学杂志》2015年07期

【摘要】：目的探讨合并2型糖尿病(T2DM)的老年患者单肺通气时血清及肺泡灌洗液中炎性因子的变化及乌司他丁(UTI)的干预效应。方法 30例接受胸腔镜手术老年患者随机分为糖尿病组(DM组),DM UTI干预组(DM-U组),每组15例。DM-U组在麻醉诱导后静脉泵注5 000 U/kg UTI,DM组静脉给予同容量的生理盐水,观测各组患者在麻醉前(T1)、麻醉后单肺通气前(T2)、手术结束前(T3)、术后24 h(T4)各时点血糖及血清中白细胞介素(IL)-2、IL-4、IL-6、IL-8、IL-10及肿瘤坏死因子(TNF)-α的变化以及T2、T3时点双肺泡灌洗液中上述炎性因子的变化;比较术后并发症的发生率。结果两组患者T3及T4时点血糖及血清中IL-6、IL-8均较T1时点升高(P0.05),DM-U组T3、T4两个时点血清中的IL-6、IL-8较DM组降低(P0.05);T3时点双肺泡灌洗液中IL-6、IL-8、TNF-α均较T2时点升高(P0.05),通气侧肺各因子较同时点非通气侧肺明显减低(P0.01),与同时点DM组比较,T3时点双肺泡灌洗液中TNF-α降低(P0.05),但IL-6及IL-8则DM组和DM-U组比较无统计学差异(P0.05)。结论单肺通气时DM患者血清中IL-6、IL-8及肺泡灌洗液中IL-6、IL-8、IL-10及TNF-α均升高,预先静脉给予5 000 U/kg UTI可抑制单肺通气时DM患者血清中IL-6、IL-8及肺泡灌洗液中TNF-α的释放。
[Abstract]:Objective to investigate the changes of inflammatory factors in serum and alveolar lavage fluid during single lung ventilation in elderly patients with type 2 diabetes mellitus (T2DM) and the intervention effect of ulinastatin (UTI).Methods Thirty elderly patients undergoing thoracoscopic surgery were randomly divided into diabetic group (DM group) and DM UTI intervention group (DM-U group). 15 patients in each group were injected intravenously with normal saline of the same volume after anesthesia induction.Changes of inflammatory factors;The incidence of postoperative complications was compared.Compared with DM group, TNF- 伪 in TNF- 伪 in TNF- 伪 decreased P0.05, but there was no significant difference between DM group and DM-U group in IL-6 and IL-8.Conclusion the levels of IL-6 IL-8 in serum and IL-8 and TNF- 伪 in alveolar lavage fluid in DM patients with single lung ventilation were increased, and 5 000 U/kg UTI could inhibit the release of IL-6 IL-8 in serum and TNF- 伪 in alveolar lavage fluid of DM patients during single lung ventilation.
【作者单位】：广州医科大学附属第一医院;南方医科大学南方医院麻醉科;
【基金】：广州市卫生局医药卫生科技项目(No:20142A010013) 广州医科大学附属第一医院青年基金项目(No:201221-gyfyy)
【分类号】：R614

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