Objective To observe changes in serum erythropoielin (EPO) and Lumor necrosis factor-atpha (TNF-α) levels in perioper-ative period of cardiopulmonary bypass ( CPB) for cyanolic and acyanotic congenital heart disease and Lo discuss the possible anti-inflammato ry effect of EPO in perioperalive period of CPB. Methods Tolally 40 patients with congenital heart disease were divided into cyanolic group and acyanolic group (re = 20). The levels of serum EPO and TNF-α were delecled and delermined before operalion and at 30 minules, 2 hours,24 hours after CPB respectively after anesthesia and blood withdrawal. Results Serum TNF-α concentration was lower in cyanolic group al 30 minules during CPB ( P < 0. 05 ) ,but it was higher at 2 hours and 24 hours afler CPB than that in acyanolic group( P < 0. 01, P < 0.05). Preoperative serum EPO concentration was negatively correlated with serum TNF-α concentration at 30 minules during CPB (P <0. 05). Conclusion There may be certain adaptive changes in cyanolic congenilal heart disease, which may inhibit the systemic inflammatory response afler CPB. The anti-inflammatory effect may correlate with EPO.%目的 通过对紫绀型先天性心脏病和非紫绀型先天性心脏病患者围体外循环(CPB)期血清促红细胞生成素(EPO)、TNF-α水平的变化进行动态观察,探讨EPO对围体外循环期炎症因子水平可能的影响.方法 40例先天性心脏病患儿,其中紫绀组和非紫绀组各20例,均在中低温体外循环下接受心内直视手术,分别于麻醉后、CPB 30 min、CPB后2 h、CPB后24 h取血,测定并比较两组患者的血清EPO和TNF-α水平变化.结果 紫绀组在CPB 30 min的血清TNF-α明显低于非紫绀组(P<0.05),在CPB后2 h、CPB后24 h的血清TNF-α高于非紫绀组(P<0.01,P<0.05);术前血清EPO水平与CPB 30 min时血清TNF-α水平呈负相关(P<0.05).结论 紫绀型先天性心脏病可能存在某种适应性改变,可在一定程度抑制CPB后的全身炎症反应,其抗炎症作用机制可能与EPO相关.
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