2021 年第 9 期 第 16 卷

参附注射液对体外循环手术患者肺保护效果的研究

The effect of Shenfu injection on lungs protection in patients undergoing cardiopulmonary bypass surgery

作者：银世杰1覃冠斌1武伟1冯志强2韦懿桐2

英文作者：Yin Shijie1 Qin Guanbin1 Wu Wei1 Feng Zhiqiang2 Wei Yitong2

单位：1广西中医药大学第一附属医院麻醉科，南宁530023；2广西中医药大学第一附属医院心胸外科，南宁530023

英文单位：1Department of Anesthesiology the First Affiliated Hospital of Guangxi University of Chinese Medicine Nanning 530023 China; 2Department of Cardio-Thoracic Surgery the First Affiliated Hospital of Guangxi University of Chinese Medicine Nanning 530023 China

关键词：体外循环；肺保护；参附注射液

英文关键词：Cardiopulmonarybypass;Lungsprotection;Shenfuinjection

• 摘要：

• 目的 观察参附注射液对体外循环手术患者肺脏的保护效果。方法 选取广西中医药大学第一附属医院2016年6月至2020年8月择期行体外循环心内直视手术患者50例，按随机数字表法分成观察组与对照组，每组25例。麻醉诱导后，观察组患者静脉输注参附注射液，负荷剂量为1 ml/kg，之后以10 ml/h的速率输注至手术结束；对照组患者给予等容量的0.9%氯化钠注射液。比较2组体外循环前后氧化应激指标［血清超氧化物歧化酶（SOD）和丙二醛］、炎症指标［肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、IL-8］、肺损伤指标［血清克拉拉细胞分泌蛋白16(CC16)和表面活性蛋白(SP-D)］水平。结果 体外循环结束时2组血清SOD水平均较体外循环开始前降低，但观察组高于对照组［（66±8）U/L比（56±9）U/L］，2组血清丙二醛水平均较体外循环开始前升高，但观察组低于对照组［（9.12±1.33）mmol/L比（12.69±1.38）mmol/L］（均P＜0.05）。体外循环结束时和体外循环结束后1 h 2组IL-6、IL-8及TNF-α水平均明显高于体外循环开始前，但观察组均明显低于对照组(均P＜0.05)。体外循环结束时2组血清CC16、SP-D水平均较体外循环开始前升高，但观察组均明显低于对照组［（8.08±0.25）μg/L比（12.03±3.06）μg/L、（14.2±3.8）μg/L比（17.9±4.7）μg/L］(均P＜0.05)。结论 参附注射液具有较强的抗氧化应激能力，可以明显降低体外循环手术患者术后炎性细胞因子水平，减轻肺组织损伤，对肺具有一定的保护作用。

• Objective To observe the effect of Shenfu injection on the lungs protection in patients undergoing cardiopulmonary bypass (CPB) surgery. Methods From June 2016 to August 2020, 50 patients undergoing elective open heart surgery during CPB in the First Affiliated Hospital of Guangxi University of Chinese Medicine were enrolled. Patients were randomly divided into the observation group and the control group, with 25 cases in each group. After induction of anesthesia, patients in the observation group were given Shenfu injection intravenous injection with a loading dose of 1 ml/kg, and then infused at a rate of 10 ml/h until the end of the operation; patients in the control group were given equal volume of 0.9% sodium chloride injection. The levels of oxidative stress indexes ［serum superoxide dismutase (SOD) and malondialdehyde(MDA)］, inflammatory indexes ［tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8］ and lung injury indexes ［serum Clara cell secretory protein 16 (CC16) and surfactant protein (SP-D)］ before and after CPB were compared between the two groups. Results At the end of CPB, the serum SOD levels of two groups were lower than those before CPB, but that of the observation group was higher than that of the control group［（66±8）U/L vs （56±9）U/L］; the serum MDA levels of two groups were higher than those before CPB, but that of the observation group was lower than that of the control group［（9.12±1.33）mmol/L vs （12.69±1.38）mmol/L］(all P＜0.05). At the end of CPB and 1 h after CPB, the levels of IL-6, IL-8 and TNF-α of two groups were significantly higher than those before CPB, but those of the observation group were significantly lower than those of the control group (all P＜0.05). At the end of CPB, the serum levels of CC16 and SP-D of two groups were higher than those before CPB, but those of the observation group were significantly lower than those of the control group［（8.08±0.25）μg/L vs （12.03±3.06）μg/L, （14.2±3.8）μg/L vs （17.9±4.7）μg/L］(all P＜0.05). Conclusions Shenfu injection has a strong ability to resist oxidative stress, can significantly reduce the level of inflammatory cytokines after CPB, reduce lungs tissue damage, and has a certain effect on the lungs protection.