1，6-二磷酸果糖对体外循环下心脏瓣膜置换术后患者肾功能的影响  

Effects of fructose-1,6-diphosphate on renal function in patients after cardiac valve replacement with CPB

作　　者：陈爱武[1] 何小京[1] 徐军美 常业恬[1] 

机构地区：[1]中南大学湘雅第二医院麻醉科,长沙市 410011

出　　处：《中华麻醉学杂志》2007年第10期877-880,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价1,6-二磷酸果糖（FDP）对体外循环（CPB）下心脏瓣膜置换术后患者肾功能的影响。方法择期在CPB下行心脏瓣膜置换术的患者40例,随机分为对照组（C组）和FDP组（F组）,每组20例。F组术中FDP 200 mg/kg注入预充液中随机转入体内,术后1～3 d均静脉输注FDP 200 mg·kg^-1·d^-1,C组静脉输注等容量生理盐水。分别于术前（T0）、术后1d（T1）、术后3d（T3）、术后5 d（T5）、术后7 d（T7）取静脉血及留取新鲜晨尿,检测尿中视黄醇结合蛋白（RBP）、N-已酰-β-D-氨基葡萄糖酐酶（NAG）、β2-微球蛋白（β2-MG）水平及血清β2-MG、肌酐（Cr）、尿素氮（BUN）浓度。结果与T0时相比,C组T（1.3）时血清BUN及Cr,T3时血清β2-MG,T（1,3,5,7）时尿β2-MG、RBP及NAG的水平升高,F组T（1.3）时尿β2-MG、RBP、T5时尿NAG的水平升高（P〈0.05）;与C组相比,F组T（1,3）时血清BUN,T3时血清Cr和β2-MG,T（1,3,5,7）时尿β2-MG、RBP及NAG的水平降低（P〈0.05）。结论FDP对CPB下心脏瓣膜置换术后肾功能产生保护作用。　Objective To investigate the effects of fructose-1,6-diphosphate（FDP）on renal function in patients after cardiac valve replacement with cardiopulmonary bypass（CPB）.Methods Forty ASAⅡorⅢpatients（17 male,23 female）aged 23-50 yr,weighing 40-70 kg undergoing cardiac valve replacement with CPB were randomly divided into 2 groups（n=20 each）：control group（C）and FDP group（F）.Anesthesia was induced with midazolam 0.1 mg/kg,fentanyl 10μg/kg and vecuronium 0.15 mg/kg and maintained with isoflurane inhalation and intermittent iv boluses of fentanyl,midazolam and vecuronium.In group F FDP 200 mg/kg was added to the priming solution and FDP was infused at 200 mg·kg^-1·d^-1on the first 3 days after operation.In group C normal saline was given iv instead of FDP.Blood samples were taken and urine was collected before operation（T0）,on the 1st,3rd,5th and 7th day after operation for determination of blood urea nitrogen（BUN） creatinine（Cr）,β2-microglobulin（β2-MG）and urinaryβ2-MG,RBP and NAG.Results（1）The 2 groups were comparable with respect to age,sex ratio,body weight,CPB time and aortic cress-clamping time.（2）BUN,Cr and serumβ2-MG level were significantly increased after operation on the 1st and/or 3rd postoperative day as compared with the baseline values before operation at T0 in control group and were significantly higher than in group F at the corresponding time points（P〈0.05）.（3）The urinaryβ2-MG concentrations,NAG and RBP were significantly increased after operation in both groups as compared to the baseline value before operation（T0）,and were significantly higher in group C than in group F（P〈0.05）.Conclusion FDP can protect renal function in patients after cardiac valve replacement with CPB.

关 键 词：果糖二磷酸盐类 心肺转流术 肾功能试验 

分 类 号：R686[医药卫生—骨科学]