瓣膜病变病人围术期神经体液因子和血流动力学改变  

The perioperative study of neurohormonal factors and hemodynamics in rheumatic valve disease

作　　者：尤斌[1] 陈英淳[1] 张桂珍[2] 欧阳川[3] 

机构地区：[1]首都医科大学附属北京安贞医院心外科,100029 [2]首都医科大学附属北京安贞医院超声心动图室,100029 [3]首都医科大学附属北京安贞医院麻醉科,100029

出　　处：《中华胸心血管外科杂志》2004年第6期348-351,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　观察瓣膜病变病人围术期神经体液因子和血流动力学变化规律 ,为临床治疗提供参考。方法　检测 2 4例瓣膜病变病人和 7例先天性心脏病病人围术期儿茶酚胺 (CA)、血管紧张素Ⅱ(AGⅡ )、醛固酮 (ALD)、心钠素 (ANP)水平及血流动力学指标。结果　瓣膜病变病人血浆CA、AGⅡ、ALD及ANP水平在术前不同程度升高的基础上 ,体外循环 (CPB)中显著升高。结论　二尖瓣病变病人表现为围术期高醛固酮血症 ,血浆去钾肾上腺素 (NE)、AGⅡ水平的显著升高是术中及术后早期循环高阻力的重要原因 ;Ovbective To study the perioperative changes in neurohormonal factors and hemodynamics in rheumatic valve disease. Methods Method: The neurohormaonal factors, including catecholamine (CA), angiotesin II (AGII), aldosterone (ALD), atrial natriuretic factor (ANP) and hemodynamics were studies in twenty-four patients with rheumatic valve disease (RVD). 7 congenital heart disease (CHD) as the control group. Results Plasma CA, AGII, ALD and ANP were higher preoperatively in RVD groups than that in CHD group, and significantly rose during cardiopulmonary bypass in RVD groups. Conclusion There is a hyperaldosteronism in patients with mitral valve disease during perioperative period. The high systemic resistance is closely related to significantly high levels of plasma NA and AGII during operation and in the early stage after operation. In patients with mitral valve disease and pulmonary hypertension, most of pulmonary pressure and resistance decrease in the early stage after operation.

关 键 词：病人 瓣膜病变 围术期 血流动力学 AGⅡ 神经体液因子 升高 ALD CA 高阻 

分 类 号：R654.2[医药卫生—外科学]