[摘 要] 目的:研究高渗盐水重复用于手术胰腺炎病人对IL-6、IL-8及血流动力学变化的影响，以探讨其可能的作用机制，为临床应用HS治疗AP提供理论依据。方法:48例重症胰腺炎手术病人随机分为A组(24例)和B组(24例)，A组在术前及术后24 h时输7.5%高渗盐水4 ml/kg，B组则在同时点输复方氯化钠溶液，分别于术后1 d、3 d、5 d、7 d、10 d、15 d进行血尿淀粉酶及白细胞计数的变化；并分别于入手术室时(T0)、术后4 h(T1)、24 h(T2)、36 小时(T3)、48 h(T4)分别测定IL-6和IL-8。结果:T1、T3时A组MAP、CVP 明显高于B组(P<0.05)，HR组间比较无差异(P>0.05)；T2时A组HR较B组低(P<0.05)，MAP、CVP组间无差异(P>0.05)；T2、T3、T4时A组IL-6、IL-8 明显低于B组(P<0.05)，且均低于T0时。血淀粉酶在术后15d内、尿淀粉酶在术后1周内组间无显著性差异(P>0.05)，但10 d、15 d时A组明显低于B组(P<0.05)；WBC则自3d起A组明显低于B组(P<0.05)。结论:高渗盐水可降低胰腺炎围手术期间的血浆IL-6、 IL-8水平，抑制全身性炎症反应，对胰腺炎伴随的全身炎性反应有肯定治疗作用。

    [关键词] 胰腺炎；高渗盐水；炎性细胞介质

    The effect of hypertonic saline on inflammatory cytokines and hemodynamics in acute pancreatitis

    ZHU Tao,LI Qing,LIU Ju-ying,et al.

    (Department of Anesthesiology,Taihe Hospital,Yunyang Medical College,Shiyan 442000,China)

    Abstract:Objective To investigate the effect of hypertonic saline on inflammatory cytokines and hemodynamics in acute pancreatitis and provide a basis for clinical application of hypertonic saline in acute pancreatitis.Methods Forty-eight patients with critical pancreatitis were randomly allocated to receive intravenously either 4 ml/kg of 7.5% hypertonic saline(n=24;group A) or compound sodium chloride(n=24;group B) at preoperation and 24 h after operation. Blood and urine amylase level and WBC count were analysed at 1 d, 3 d,5 d,7 d,10 d,15 d after operation; IL-6 and IL-8 were measured at the time of entering operation room(T0) and at 4 h(T1),24 h(T2),36 h(T3),48 h(T4) after operation.Results At T1, the mean arterial pressure (MAP) and central venous pressure (CVP) in group A were significantly higher than that in group B(P<0.05),and heart rate(HR) in group A did not differ from that in group B(P>0.05; at T2, HR in group A was significantly lower than in group B(P<0.05),and there was not difference in MAP and CVP between both groups(P>0.05); at T3, MAP and CVP in group A were significantly higher than that in group B(P<0.05),and there was not difference in HR between both groups(P>0.05). At T2,T3 and T4, IL-6 and IL-8 in group A were significantly lower than that in group B and than at T0 in group A(P<0.05). in 15d after operation and in 1w after operation was not different between both groups(P>0.05);while blood amylase and urine amylase in group A was significantly lower than in group B at 10d ......