The Protective Effect Of PGE1Against Lung Ischemia-reperfusion Injury In Patients Undergoing Cardiac Valve Replacement Surgery With Cardiopulmonary Bypss(CPB)

Objective:To evaluate the protective effect of PGE1against lung ische-mia-reperfusion injury in patients undergoing cardiac valve replacement sur-gery with cardiopulmonary bypss(CPB).Methods:Thirty patients undergoing cardiac valve replacement surgerywith CPB were randomly divided into two groups,test group (n=15) andcontrol group (n=15).There is no remarkable difference between the twogroups in age,body weight,sex ratio,heart function,LVEF.The patients in testgroup received respectively2ng PGE1injection per kilogram body weigt perminute in the cold blood cardioplegic solution of cardiopulm-onary bypassunit at5min after anesthesia induction before operation;While in controlgroup did not receive the treatment. The methods of CPB and infusionin the two groups were the same.Blood samples were taken from the radial artery blood at the followingtime points:(1)after anesthesia induction before operation(T1);(2)2hours af-terCPB (T2);(3)4hours after CPB(T3);(4)12hours after CPB(T4);ThenThecontent ofIL-6,IL-8,TNF-a in plasma of all blood samples was test,and all ofthe bloods were estimated by ELISA (enzyme-linked immunosorbentassay).At the same time,inhaled oxygen concentration and arterial blood gasanalysis were recorded for calculation of oxygen index (OI)and respiratoryindex (RI). In the mean time,we observed and recorded some indexes of thetwo groups:the CPB time,aorta-occlusion time,supplementary circulation timeResults：1There is no striking difference between the two groups in the plasmaconcentrations of inflammatory cytolines and respiratory functional parame-ters (P>0.05)． 2The change of the plasma level of IL-6:Compare with the plasma level of IL-6at T1，the plasma level of IL-6at T2-T4were significantly higher P<0.01),while the IL-6level of the PGE1group is lower than the control group at T2-4（P<0.05）.3The change of the plasma level of IL-8:Compare with the plasma level of IL-8at T1，the plasma level of IL-8at T2-T4were significantly higher (P<0.01), while the IL-6level of the PGE1group is lower than the control group at T2-T4（P<0.05）4The change of the plasma level of TNF-a:Compare with the plasma level of TNF-a at T1，the plasma levelofTNF-a at T2-4were significantly higher (P<0.01),while the TNF-a level of thePGE1group is lower than the control group at T2-4（P<0.05）5The change of the oxygen index of the two groups:There is no striking difference between the two groups of the oxygenindex at T1,after the CPB,the oxygen index at T2-T4is lower than thetime point1(P<0.01）. Compare with the control group,the PGE1group ishigher at T3-4（P<0.05）.6The change of the insipiratory index of the two groups：There is no significant difference between the two groups of theinsipiratory index at T1(P>0.05)，the insipiratory index at T2-4is higher thanthe time point1in the two groups (P<0.01），the insipiratory index of thePGE1group is lower than that of the control group （P<0.05）Conclusions:Inflammatory responses occur during and after CPB in bothgroup patients.PGE1can inhibit the inflammatory cytokine releaseand reducethe inflammatory response,reduce the plasma levels of IL-6,IL-8and TNF-alessen the lung inflammatory response to CPB.It has good effects on lungprotection in CPB in patients undergoing cardiac valve replacement.