Penehyclidine Influencing Cytokines Of Infant With Congenital Heart Disease During Cardiopulmonary-bypass

Objective: To study Penehyclidine influencing cytokines of infant with congenital heart disease during and after cardiopulmonary bypass and it' s protection to infant.Material and Methods: Sixty children suffered from congenital heart disease were studied, male forty-four cases, female sixteen cases, age from eight months to three years, body weight from five to fifteen kilograms. They were tetralogy of fallotFallot(TOF) twenty-four cases, ventricular septal defect (VSD)twenty-four cases, atrial septal defect (ASD) complicating VSD and pulmonary artery hypertension twelve cases. They were randomly divided into three groups:Penehyclidine group one (group P₁), Penehyclidine group two (group P₂), and control group (group C),twenty cases respectively. Group p₁ were intramuscularly injected Penehyclidine 0. 02mg/kg thirty minutes before operation. Group P₁ wereintramuscularly injected Penehyclidine 0.02 mg/kg thirty minutes before operation., 24 hours and 48 hours after operation. Group C were intramuscularly injected atropine 0.02mg/kg thirty minutes before operation. The three groups were observed temperature and heart rate(HR) thirty minutes before and after operation. And they were monitoring arterial pressure, heart rate, saturation of blood oxygen, electrocardiogram, partial pressure of carbon dioxide in endexpiratory gas and body temperature. By radioimmunity the arterial blood taking from the children were determined the contents of tumor necrosis factor , interleukin-2, interleukin-6 and interleukin-8 before operation, thirty minutes after CPB, the end of CPB, twenty-four hours and forty-eight hours postoperatively. Their salivary secretion and X-ray plate of chest were examined postoperatively.Results: 1. Before and after administration their body temperature and HR of group Pi and group P2 were no significant change. HR of group C was significant higher than preadministration(P<0. 05) and was significant higher than group P! and group P2.2. The cytokine change in three groups TNF- a : Before CPB, the value of TNF-a in three groups was no significant deviation. At the beginning of CPB the value of TNF-a in three groups was significant high. At the end of CPB the value of TNF-a in three groups was the highest, and the highest value of group P: and P2 was significant lower than group C(P<0. 05).Postoperatively, the value of group P2 on the 24th hour and the 48th hour was lower than group C(P<0. 05).IL-2: Before and after CPB , on the 24th hour and the 48th hour postoperatively, the variation of the value of IL-2 in three groups was no significant deviation.IL-6> IL-8: Before CPB, the value of IL-6 and IL-8 in three groups was no significant deviation. At the beginning of CPB the value of IL-6 and IL-8 in three groups increased . At the end of CPB the value in three groups was the highest, and the highest value of group Pt and P2 was significant lower than group C(P<0.05). Postoperatively, the value of group P2 on the 24th hour and the 48th hour was lower than group C(P<0. 05).3. Postoperatively, the secretion of group P2 was significant lower than group Pi and group C(P<0. 05).4. The bellows condition by X-ray plate: Postoperatively, pneumonia incidence rate was forty-three percent in group C, thirty-six percent in group ?i, seventeen percent in group P2, and pneumonia incidence rate in group P2 was significant lower than the other groups (P<0.05).Conclusion: 1. Penehyclidine was better on keeping HR stabilization of congenital heart disease in children during operation and had good results on avoiding increase of rnyocardial consumption of oxygen due to HR increase. Then it protected cardia insufficient congenital heart disease .2. Penehyclidine injected before and after operation can better suppress the free of inflammatory cytokines than only before operation. And it lessened inflammatory reaction and pneumonia after CPB. Then it improved the prognosis of congenital heart disease on operating.3. Penehyclidine injected before operation and after operation can better suppress the secretion of lungs and air tube than only before operation. And it can better improve lung microcirculation and lung ventilation. Then the children suffered from congenital heart disease could be better treated during operation and after operation.4. Penehyclidine was better in affecting congenital heart disease in children than atropine in preoperative adiminitration.