2026 年第 9 期 第 21 卷

体外循环中HA380血液灌流技术对心脏直视手术患者围手术期炎症状态及术后早期认知功能的影响

Effects of HA380 hemoperfusion technology during cardiopulmonary bypass on perioperative inflammatory status and early postoperative cognitive function in patients undergoing open heart surgery

作者：胡振飞程虎李帆黄一丹

英文作者：Hu Zhenfei Cheng Hu Li Fan Huang Yidan

单位：新疆医科大学第一附属医院麻醉科，乌鲁木齐830000

英文单位：Department of Anesthesiology the First Affiliated Hospital of Xinjiang Medical University Urumqi 830000， China

关键词：心脏直视手术；血液灌流；炎症；认知功能

英文关键词：Open-heartsurgery;Hemoperfusion;Inflammation;Cognitivefunction

• 摘要：

• 目的 探究体外循环中HA380血液灌流技术对心脏直视手术患者围手术期炎症状态及术后早期认知功能的影响。方法 选取2023年6月至2024年8月140例于新疆医科大学第一附属医院行体外循环心脏手术的患者。根据术中是否使用HA380血液灌流器治疗将患者分为对照组（72例）和观察组（68例）。比较2组患者炎症因子水平［白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、环氧合酶2、C反应蛋白（CRP）］、术后谵妄和认知能力［采用重症监护病房意识模糊评分量表、蒙特利尔认知评估量表（MoCA）评估］、脑损伤标志物水平［S100钙结合蛋白β（S100β）、神经元特异性烯醇化酶（NSE）］、不良反应发生率及术后30、90 d死亡率情况。结果 观察组IL-6、TNF-α、环氧合酶2、CRP水平，谵妄发生率、S100β、NSE水平均低于对照组，术后1、3 d的MoCA评分均高于对照组［（25.6±2.6）分比（22.5±2.3）分、（26.6±2.7）分比（24.8±2.5）分］（均P<0.05）。2组不良反应发生率以及术后30、90 d死亡率比较差异均无统计学意义（均P>0.05）。结论 体外循环中HA380血液灌流技术可显著降低心脏直视手术患者围手术期炎症因子和脑损伤标志物水平，改善患者认知功能，且安全性较高。

• Objective To explore the effects of HA380 hemoperfusion technology during cardiopulmonary bypass on perioperative inflammatory status and early postoperative cognitive function in patients undergoing open heart surgery. Methods A total of 140 patients undergoing cardiopulmonary bypass-assisted cardiac surgery in the First Affiliated Hospital of Xinjiang Medical University from June 2023 to August 2024 were enrolled. Patients were divided into control group (72 cases) and observation group (68 cases) according to whether HA380 hemoperfusion cartridge was used intraoperatively. The two groups were compared in terms of inflammatory factor levels ［interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), cyclooxygenase-2, C-reactive protein (CRP)］, postoperative delirium and cognitive function ［assessed using the confusion assessment method for the intensive care unit and Montreal cognitive assessment (MoCA)］, brain injury marker levels ［S100 calcium-binding protein β (S100β), neuron-specific enolase (NSE)］, incidence of adverse reactions and 30-day and 90-day postoperative mortality. Results The levels of IL-6, TNF-α, cyclooxygenase-2, CRP, delirium rate, S100β and NSE in the observation group were lower than those in the control group, while the MoCA scores at postoperative day 1 and 3 were higher than those in the control group ［(25.6±2.6) vs (22.5±2.3), (26.6±2.7) vs (24.8±2.5)］(all P<0.05). There were no statistically significant differences in the incidence of adverse reactions and 30-day, 90-day postoperative mortality between the two groups (all P>0.05). Conclusion HA380 hemoperfusion technology applied during cardiopulmonary bypass can significantly reduce perioperative levels of inflammatory factors and brain injury markers, improve cognitive function with favorable safety profile in patients undergoing open heart surgery.