尼群地平在体外循环中对红细胞的保护作用  

Protective Effect of Nitrendipine on Erythrocytes during Cardiopulmonary Bypass

作　　者：王涛[1,2] 张善通[1,2] 曹金红[1,2] 

机构地区：[1]上海医科大学儿科医院心血管中心 [2]青岛市儿童医院心血管中心

出　　处：《中华胸心血管外科杂志》1999年第1期10-12,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的：研究体外循环中红细胞钙与损伤的关系及钙拮抗剂对红细胞的保护作用。方法：４０例非紫绀型先天性心脏病病人随机均分为对照组与尼群地平组。尼群地平组术前７日口服尼群地平，每次０．５ｍｇ／ｋｇ，每８小时１次，测定围体外循环期红细胞钙（ＥＣａ２＋），Ｃａ２＋，Ｍｇ２＋ＡＴＰａｓｅ与Ｎａ＋，Ｋ＋ＡＴＰａｓｅ活性、滤过指数（ＩＦ）、平均体积（ＭＣＶ）、血浆游离血红蛋白（ＦＨｂ），观察红细胞形态变化。结果：对照组体外循环中ＥＣａ２＋、ＩＦ、ＭＣＶ、ＦＨｂ进行性增加，Ｃａ２＋，Ｍｇ２＋ＡＴＰａｓｅ与Ｎａ＋，Ｋ＋ＡＴＰａｓｅ活性下降，红细胞发生严重棘状变形，ＥＣａ２＋与ＩＦ、ＭＣＶ、ＦＨｂ直线正相关。而尼群地平组上述各项指标变化均明显减轻（Ｐ＜０．０５）。结论：体外循环中红细胞钙增加是其主要损伤机制之一，尼群地平具有良好保护作用。Aim:This stady was conducted to evaluate the relationship between erythrocyte injury and calcium,and the protective effect of calcium antagonists on erythrocytes during cardiopulmonary bypass(CPB).Clinical material and method:Forty patients with congenital heart disease underwent surgical repair under CPB.The patients were randomly divided into two groups.Control group(n=30)received no medications before surgery.Nitrendipine group received nitrendipine(0.5mg/kg,t.i.d)orally seven days before surgery.The blood samples were taken at five different time intervals for assessing the content of erythrocytes calcium(E Ca 2+ ), activities Ca 2+ Mg 2+ ATPase,Na + K + ATPase,index filtration of erythrocytes(IF),mean corpuscular volume(MCV)and plasma free hemoglubin(F HB).Results:In control group,E Ca 2+ ,IF,MCV and F Hb were gradually increased and activities Ca 2+ Mg 2+ ATPase and Na + K + ATPase were decreased .The reduction of E Ca 2+ was closely related to IF,MCV and F Hb.In nitrendipine group,all abovementioned parameters were significantly improved.Conclusion:This study suggests that erythrocyte injury is related to elevation of intracellular calcium during CPB and preoperative treatment with nitrendipine can reduce erythrocyte injury.

关 键 词：尼群地平 体外循环 红细胞钙 红细胞保护 

分 类 号：R654.1[医药卫生—外科学] R972.4[医药卫生—临床医学]