Aminophylline Cpb, The Expression Of Mip-2 Lung Protective Effect

Objective: This study attempted to investigate the protective effect of aminophylline on lung during Ischemia/Reperfusion injury induced by Cardiopulmonary Bypass,and explore its possible mechanisms.Methods: Twenty patients with rheumatic heart valve disease scheduled for elective valve replacement were randomly divided into two groups of 10 each: aminophylline group and control group. In aminophylline group, aminophylline(5mg/Kg) was injected slowly via vein in five minutes after anesthesia induced and maintained with 0.5mg/Kg·h dose by micro-pump until the end of CPB. In control group, aminophylline was replaced by same volume of lactated Ringer solution. Blood samples were taken from radial artery after post-anethesia induction, aaortic cross-clamp 30 minutes and after-CPB 1 hours,6 hours, then the content of myeloperoxidase(MPO),malondialdehyde(MDA),superoxide dismutase(SOD)in blood serum of all blood samples was tested. Blood samples were taken from radial artery after aortic cross-clamp 30 minutes,then the content of tumor necrosis factor-α(TNF-α)was tested.Blood samples were taken from left atrium after aortic cross-clamp and aortic cross-clamp 30 minutes,then the content of macrophage inflammatory protein-2(MIP-2) and tumor necrosis factor-α(TNF-α)was tested. Recorded the operation time, CPB time, aortic cross-clamp time, mechanical ventilation time, urine volumes of 24 hours, RI, OI..Results: The mean gender, mean age, mean weight, mean cardiac function, mean operation time, mean CPB time and aortic cross-clamp time were no statistical difference between aminophylline group and control group(P>0.05).No death occurred. The MPO concentration,MDA concentration and SOD concentration were not significantly different after post-anethesia induction between the two groups. But after aortic cross-clamp 30 minutes,1h and 6h after CPB, MDA level was significantly higher than the baseline value after post-anethesia induction in control group and that in aminophylline group(P<0.05); The SOD concentration greatly decreased after aortic cross-clamp 30 minutes,1h and 6h after CPB in both groups as compared with that after post-anethesia induction, but was much lower in the control group than that in the aminophylline group(P<0.05); after aortic cross-clamp 30 minutes,1h after CPB and 6h after CPB, MPO level was dignificantly higher than the baseline value after post-anethesia induction in control group and that in aminophylline group(P<0.05);The MIP-2 concentration was not significantly different after aortic cross-clamp between the two groups, but after aortic cross-clamp 30 minutes, it was much higher in the control group than that in the animophylline group(P<0.05); The TNF-αconcentration from left atrium blood was not significantly different after aaortic cross-clamp between the two groups, but after aortic cross-clamp 30 minutes, it was much higher in the control group than that in the animophylline group(P<0.05); After aortic cross-clamp 30 minutes, the MIP-2 concentration and the TNF-αconcentration from left atrial were significantly positive correlation(P<0.05); After aortic cross-clamp 30 minutes, the MIP-2 concentration from left atrial and the TNF-αconcentration from radial artery were significantly positive correlation(P<0.05); After aortic cross-clamp 30 minutes, the MIP-2 concentration from left atrial and the MPO concentration from radial artery were significantly positive correlation(P<0.05);During operation, the RI of the two groups gradually increased trend, the RI of aminophylline group was dignificantly lower than the RI of the control group(P<0.05); During operation, the OI of the two groups gradually Declined trend, the OI of aminophylline group was dignificantly highe than the OI of the control group(P<0.05).Conclution: Aminophylline treatment could protect lung function during CPB, it might reduce the inflammatory response by blocking the expression of MIP-2,reducing the oxygen free radical injury by CPB in patients undergoing valve replacement.