Protective effect of Tanreqing injection on the lung during heart valve replacement

doi:10.3969/j.issn.2095-4344.2013.05.013

Abstract

Abstract:

BACKGROUND: Cardiopulmonary bypass for open heart surgery can cause acute lung injury, and there are many reports on the traditional Chinese medicine in reducing lung injury.
OBJECTIVE: To evaluate the protective effect of Tanreqing injection on acute lung injury during cardiopulmonary bypass in patients undergoing heart valve replacement.
METHODS: A total of 40 patients undergoing heart valve replacement were randomly divided into Tanreqing group and control group (20 in each group). In Tanreqing group, intravenous drip of 20 mL of Tanreqing injection mixed with 250 mL normal saline was given the night before operation and prior to cardiopulmonary bypass, respectively, while in the control group, intravenous drip of 250 mL normal saline was given. Serial blood samples of radial artery were collected at the following intervals: prior to cardiopulmonary bypass, 40 minutes after cardiopulmonary bypass and 0, 2, 6 and 24 hours after the end of cardiopulmonary bypass. Then the amount of neutrophil was measured with hematology analyzer; the serum levels of soluble intercellular adhesion molecule-1 and interleukin-8 was detected with double-antibody sandwich enzyme linked immunosorbent assay methods. Neutrophil ratio of right and left atrium cordis (transpulmonary polymorphonuclear) was calculated before cardiopulmonary bypass and immediately after the end of cardiopulmonary bypass, and the transpulmonary difference was calculated. We also calculated pulmonary dynamic compliance and respiratory indexes before valve replacement and skin incision, 10 minutes after the termination of cardiopulmonary bypass, at the end of surgery and 4 hours after the end of surgery, respectively.
RESULTS AND CONCLUSION: The amount of neutrophil, intercellular adhesion molecule-1, interleukin-8 at different time points after cardiopulmonary bypass were significantly higher than those before cardiopulmonary bypass (P < 0.01), but levels of those in Tanreqing group were significantly lower than those in the control group (P < 0.01). The transpulmonary difference at the end of cardiopulmonary bypass was significantly higher than that before cardiopulmonary bypass (P < 0.01), and the transpulmonary difference in the Tanreqing group was significantly lower than that in the control group (P < 0.01). The respiratory indexes of the two groups were increased compared with those before valve replacement and skin incision (P < 0.01). The pulmonary dynamic compliance of the two groups was significantly decreased compared with that before cardiopulmonary bypass (P < 0.01), and then returned to the level before skin incision at 4 hours after the end of valve replacement. The respiratory index in the Tanreqing group was lower than that in the control group (P < 0.05). The pulmonary dynamic compliance after valve replacement in the Tanreqing group was higher than that in the control group (P < 0.01). Tanreqing injection can reduce the lung injury after valve replacement and protect the lung.

Key words: organ transplantation, heart-lung transplantation, heart valve, prosthesis implantation, Tanreqing injection, cardiopulmonary bypass, acute lung injury, inflammation, soluble vascular cell adhesion molecule 1, interleukin-8, respiratory index, lung dynamic compliance, other grants-supported paper

CLC Number:

R318

Shao Lian-bin, Yang Xiao-gang, Yang Hai-ping, Liu Wen-li, He Jin-xi, Bian Hong. Protective effect of Tanreqing injection on the lung during heart valve replacement[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(5): 843-850.

Figures/Tables 5

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