乌司他丁通过诱导miR-155抑制体外循环心脏手术患者炎症反应的作用机制研究

发布时间：2018-06-14 20:52

本文选题：乌司他丁 + 体外循环　；参考：《中国药房》2017年20期

【摘要】：目的:研究乌司他丁在体外循环(CPB)心脏手术中对患者炎症因子抑制作用的机制。方法:选取2012年7月-2016年7月于我院择期行CPB心脏手术的40例患者为研究对象,按照随机数字表法分为对照组和观察组,各20例。观察组患者于麻醉诱导后即给予30万U乌司他丁静脉泵注,以2.5 m L/min的速率在20 min内完成,再将70万U乌司他丁以0.2 m L/min的速率使用微量泵持续静脉泵注至术毕;对照组患者给予等容量生理盐水。分别于麻醉诱导前(术前)和CPB停止(术后)6、12、24 h采集患者血液标本,以实时定量逆转录聚合酶链反应和蛋白质免疫印迹法检测外周血单核细胞中微小核糖核酸155(mi R-155)及其靶基因髓样分化因子88(My D88)的表达情况;以酶联免疫吸附测定法检测血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和IL-8的表达情况;采用Pearson相关系数分析观察组患者术后24 h的mi R-155与TNF-α、IL-6、IL-8表达的相关性。结果:与对照组比较,观察组患者的mi R-155表达水平显著升高,其靶基因My D88的表达水平显著降低,炎症因子TNF-α、IL-6、IL-8的表达水平显著降低,差异均有统计学意义(P0.01)。观察组患者术后24 h的mi R-155与TNF-α、IL-6、IL-8的表达水平呈显著负相关(P0.01)。结论:乌司他丁可通过诱导mi R-155的表达来抑制炎症因子TNF-α、IL-6、IL-8的释放,这可能是该药在CPB心脏手术中发挥抗炎作用的新机制。
[Abstract]:Aim: to investigate the inhibitory mechanism of ulinastatin on inflammatory cytokines in patients undergoing cardiopulmonary bypass (CPB) cardiac surgery. Methods: from July 2012 to July 2016, 40 patients undergoing CPB cardiac surgery in our hospital were selected and divided into control group (n = 20) and observation group (n = 20). In the observation group, 300000 U ulinastatin was injected intravenously at a rate of 2.5 mL / min within 20 min immediately after anesthesia induction, and 700000 U ulinastatin was continuously injected with a micropump at the rate of 0.2 mL / min until the end of the operation. The patients in the control group were given normal saline of equal volume. Blood samples were collected before anesthesia induction (pre-operation) and CPB cessation (12 hours after operation). The expression of 155(mi R-155) and its target gene myeloid differentiation factor 88My D88 in peripheral blood monocytes were detected by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blot. The expression of TNF- 伪 TNF- 伪, interleukin-6 (IL-6) and IL-8 were detected by enzyme-linked immunosorbent assay (Elisa), and the correlation between MIR-155 and TNF- 伪 IL-6IL-8 was analyzed by Pearson correlation coefficient. Results: compared with the control group, the expression of mi R-155 was significantly increased, the expression of my D88 and the expression of inflammatory factor TNF- 伪, IL-6, IL-8 were significantly decreased in the observation group, and the difference was statistically significant (P 0.01). In the observation group, there was a significant negative correlation between the expression of MIR-155 and TNF- 伪 IL-6 + IL-8 at 24 hours after operation (P 0.01). Conclusion: Ulinastatin can inhibit the release of the inflammatory factor TNF- 伪 and IL-6 IL-8 by inducing the expression of mi R-155, which may be a new mechanism of anti-inflammatory effect of Ulinastatin in CPB cardiac surgery.
【作者单位】：新乡市第一人民医院心胸外科;
【分类号】：R614

【相似文献】