Effects Of Aminophylline On Cardiopulmonary Function And Cytokines In Patients With Sepsis

Object:To observe the effects of aminophylline on Cardiopulmonary function and cytokines in patients with sepsis.Methods:60sepsis cases with APACHE II score>16points were randomly divided into the observation group and the control group (n=30cases). Mechanical ventilation, antibiotics according to susceptibility or the sites of infection, early goal-directed therapy and intravenous infusion of small doses of adrenal cortex hormone therapy were administered in both groups, intravenous infusion of aminophylline was added in the observation group.administered with the loading dose8mg/Kg in30minutes and then with the speed of0.4mg/kg/h continuous4-days infused. Conventional radial artery was cannulated.connecting MX950T sensors and the Vigileo monitoring instrument to adjust the infusion rate according to stroke volume variation. Cardiac index, stroke volume variation and invasive arterial blood pressure were continuously monitored.arterial blood was extracted for blood gas analysis calculating oxygenation index before(TO),24(Tl),48(T2)and72h(T3)after aminophylline infusion.3ml peripheral venous blood was collected respectively for determination of aminophylline plasma concentration and plasma cytokines IL-2, IL-4, IL-6, IL-8, IL-10and IFN-y and TNF-a levelResults:The age, gender composition, height, weight and APACHE II scores of two groups were not statistically significant (P>0.05); compared with the control group, the Observer Group of the total daily infusion was not statistically significant (P>0.05); compared with the control group, plasma cytokines TNF-alpha, IL-2. IL-4, IL-6. IL-8, IL-10and IFN-gamma, cardiac index, oxygenation index and urine output in the observation group.were no significant difference before intravenous infusion of aminophylline (P>0.05). Compared with TO. the plasma TNF-alpha, IL-2, IL-6, IL-8and IFN-y levels in two groups decreased, IL-10levels (p<0.005)eIevated; compared with the control group, plasma TNF-alpha, IL-2JL-4. IL-6and IFN-y levels in the observation group obviously decreased at T2and T3,(p<0.05), IL-10levels (p <0.05)increased significantly, compared with TO. oxygenation index and urine output in both groups increased (p<0.005), compared with the control group, the observation group oxygenation index and urine output increased at Tl, T2and T3(p<0.05). compared with the control group, the observation group TO cardiac index difference was no statistically significant (P>0.05), Tl and T3cardiac index increased (p <0.05).Conclusion:1.intravenous infusion of aminophylline can increase urine output,oxygenation index and cardiac index in patients with sepsis;2.aminophylline can effectively reduce proinflammatory cytokines IL-2, IL-6, TNF-alpha levels and elevate anti-inflammatory factor IL-10levels in patients with sepsis;3.aminophylline can mitigate the severity of capillary leak by improving cardiopulmonary function and inhibiting inflammatory response in patients with sepsis.