添加紫外线照射充氧血预充液对体外循环心脏瓣膜置换手术红细胞脂质过氧化的影响  

Protective effect of ultraviolet blood irradiation and oxygenation added to cardiopulmonary-bypass circuit priming on erythrocyte lipid peroxidation in patients undergoing heart valve replacements with cardiopulmonary bypass

作　　者：周涛[1] 向道康[1] 周亮贤 舒义竹[1] 吴学志[1] 张大国[1] 阎兴治[1] 

机构地区：[1]贵州省人民医院心脏外科,贵阳市550002

出　　处：《实用医学杂志》2009年第19期3221-3223,共3页The Journal of Practical Medicine

基　　金：贵州省自然科学基金(编号:黔科通[2003]50号)

摘　　要：目的:研究使用添加紫外线照射充氧血预充液对体外循环心脏瓣膜手术患者红细胞脂质过氧化的影响。方法:48例行体外循环心脏瓣膜置换手术患者,分为治疗组和对照组(各24例),治疗组于全身血液肝素化后通过锁骨下静脉按10mL/kg体重采血或使用库存血细胞行紫外线照射并充氧后加入预充液,对照组使用等量生理盐水,两组预充液中其他成分相同,其他处理两组相同。两组均于麻醉诱导后、转机30min、开放主动脉30min、术后第1天采桡动脉血测定血浆脂质过氧化物(PLPO)、红细胞脂质过氧化物(ELPO)浓度和红细胞超氧化物歧化酶(ESOD)活性。结果:两组患者体外循环后PLPO、ELPO浓度均有明显上升,ESOD活性在开放主动脉30min后有所上升随后明显下降(P<0.05),治疗组体外循环开始后各时间点PLPO,ELPO水平低于对照组,ESOD水平在开放主动脉后各时间点高于对照组(P<0.05)。结论:使用添加紫外线照射充氧血预充液具有减轻体外循环心脏瓣膜手术患者红细胞脂质过氧化作用。Objective To investigate the protective effect of ultraviolet blood irradiation and oxygenation （UBIO） added to cardiopuhnonary-bypass circuit priming on erythrocyte lipid peroxidation in patients undergoing heart valve replacements during and after cardiopuhnonary bypass （CPB）. Method Forty- eight patients undergoing elective heart valve replacements with CPB were randomly divided into control group （n = 24） and test group （n = 24）. In test group, UBIO accumulated from the subclavian vein （10 mL/kg） or blood bank was dealt with the ultraviolet irradiation （wave length 240 - 300 nm） and oxygenation （FiO2 100%）, and the UBIO was added into cardiopulmonary-bypass circuit priming before CPB while in the control group equivalent quantitative saline was added. Blood samples were collected from radial arterial after induction of anaesthesia, 30 min after initiation of CPB, 30 min after aorta declamping and 24 h after surgery for dynamically detecting the changes of plasma and erythrocyte LPO （PLPO and ELPO） and erythrocyte superoxide dismutase （ESOD）. Results The levels of PLPO and ELPO increased significantly after initiation of CPB . The level of ESOD at 30 rain after aorta declamping was higher than the level of induction of anaesthesia and decreaseded at 30 rain after aorta declamping and 24 h after surgery . The levels of PLPO and ELPO were significantly lower in the test group than those in the control group while ESOD level was markedly higher than that in the control group （P 〈 0.05）. Conclusion UBIO added to cardiopulmonary-bypass eircuit priming can markedly mitigate erythrocyte lipid peroxidation caused by CPB in patients undergoing undergoing heart valve replacements with CPB.

关 键 词：心肺转流术 心脏瓣膜假体植入 红细胞 脂质过氧化物类 紫外线照射充氧血 

分 类 号：R654.2[医药卫生—外科学]