逆行灌注心脏不停跳联合瓣膜置换术中内皮素的变化  

The changes of atrial natriuretic peptide and endothlin-1 in retrograde heart surgery in beating heart

作　　者：冯旭[1] 林辉[2] 何巍[1] 陈铭伍[1] 覃家锦[1] 周华富[1] 郑宝石[1] 

机构地区：[1]广西医科大学第一附属医院心胸外科,南宁530021 [2]广西壮族自治区人民医院

出　　处：《广西医学》2005年第2期172-173,共2页Guangxi Medical Journal

基　　金：广西壮族自治区自然科学基金项目

摘　　要：目的　探讨逆行灌注心脏不停跳联合瓣膜置换术对心肌保护效果。方法　将 30例风湿性心脏病二尖瓣及主动脉瓣联合病变的患者随机分为实验组 (浅低温逆行灌注心不停跳组 )与对照组 (中度低温心停跳组 ) ,每组 15例 ,体外循环 (CPB)15 0min。于 6个时点采静脉血 ,检测血浆内皮素 (ET)。结果　转机后ET持续升高 ,逆灌开始 90min至CPB后与CPB前比较差异有统计学意义 (P <0 .0 5 )。对照组阻断主动脉后 6 0min至CPB后与CPB前比较差异有统计学意义 (P <0 .0 5 )。实验组与对照组转机前比较差异无统计学意义 (P >0 .0 5 ) ,转机 6 0、90、12 0min ,主动脉开放 30min及CPB后对照组较实验组升高明显 ,差异有统计学意义 (P <0 .0 5 )。结论　逆行灌注心脏不停跳联合瓣膜置换术减少了ET的合成及释放 。Objective To study the myocardial protective effects on retrograde perfusion via coronary sinus in beating heart.Methods Thirty patients undergoing united cardio valve replacement were randomly divided into experimenta group( with mild hypothermic retrograde perfusion via coronary sinus in beating heart,n=15)and control group(on arrest heart with mide hypothermic).Cardiopulmonary bypass(CPB) was performed for 150 minutes . Plasma endothlin-1 of tow groups were respeptively measured and contrasted at six different time intervals.Results ET in control group increased more quickly.Conclusion Plasma ET may be sensitive detective guideline in myocardial protective effects.Beating heart are propitious to the redued composing and releasing of ET.The myocardial protective effects in experimental group is superior to that in control group.

关 键 词：逆行灌注 内皮素 心脏不停跳 瓣膜置换术 心肌保护 

分 类 号：R654.2[医药卫生—外科学]