Study Of Ligustrazine On Lung Protection During Cardiopulmonary Bypass In Patients Underwent Valve Replacement Surgery

ObjectiveTo investigate the effects of ligustrazine on lung protection during cardiopulmonary bypass in patients underwent valve replacement operation.MethodsForty-four patients underwent heart valve replacement surgery were randomly divided into two groups, the study group (n=22) and the control group (n=22). There was no obvious difference between the two groups in sex, age, weight, operation, CPB time and aorta clamped time. Both groups were administrated with routine supportive treatment. Using Ligustrazine as a lung protective agent add in the priming solution in the study group, Peripheral blood samples were collected in both groups respectively after induction of anesthesia,5 minutes after aortic-off clamping, the end of the CPB,2 and 24 hours after CPB termination. Then the content of tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) in plasma of all blood samples was estimated. Arterial blood gas analysis was monitored at the end of CPB,2,6and24 hours after CPB termination in both groups respectively. The oxygenation index (OI) and the alveolar-arterial oxygen difference (A-aDO2) were calculated for evaluating lung function.Results1.The plasma tumor necrosis factor-α(TNF-α) and interleukin-8 (IL-8) increased at every time point after the aorta was clamped in both groups.2. The content of TNF-α, IL-8 in both groups at 5 minutes after aortic-off clamping, the end of the CPB,2 hours after CPB termination were obviously higher than those of induction of anesthesia(P<0.05).2. The peak of plasma TNF-αappeared at hours after CPB termination and plasma TNF-αappeared at the end of CPB.3. The difference of TNF-α, IL-8 in study group was less than in control group(P<0.05), especially at the time points of the end of the CPB,2 hours after CPB termination.4. Compared with the control group at 24 hours after CPB termination, the alveolar-arterial oxygen partial pressure difference (A-aDO2) was significantly lower in the study group (P<0.05). Compared with the control group at 6 and 24 hours after CPB termination oxygenation index (OI) was significantly higher in the study group (P<0.05).Conclusion1. Cardiac operations with cardiopulmonary bypass can induce inflammatory response characterized by significant increase in plasma levels of IL-8 and TNF-α.2. Cardiac operations with cardiopulmonary bypass can influence the gas exchange function and cause lung injury characterized by reducing the oxygenation index (OI) and increasing the alveolar-arterial oxygen partial pressure difference (A-aDO2).3. Using Ligustrazine add in the priming solution can significantly decrease in plasma levels of IL-8 and TNF-αafter open heart surgery in CPB.4. Ligustrazine can inhibit inflammatory response effectively which reduce the injury of lung caused by CPB and facilitate their postoperative recovery of valve replacement.