盐酸戊乙奎醚对围体外循环期患者血浆肠型脂肪酸结合蛋白和D-乳酸浓度的影响  

Effect of penehyclidine hydrochloride on the concentration of blood I-FABP and D-Lactate during cardiopulmonary bypass in patients undergoing open heart surgery

作　　者：孙莹杰[1] 张丽丽 宋丹丹[1] 刁玉刚[1] 张铁铮[1] 

机构地区：[1]沈阳军区总医院麻醉科,沈阳110016 [2]松原市同心医院麻醉科

出　　处：《中国体外循环杂志》2011年第2期78-81,共4页Chinese Journal of Extracorporeal Circulation

基　　金：辽宁省博士启动基金资助项目(20091099)

摘　　要：目的探讨盐酸戊乙奎醚对围体外循环期患者血浆肠型脂肪酸结合蛋白（I-FABP）和D-乳酸浓度的影响。方法 40例拟在体外循环下行心脏瓣膜置换术患者,随机分为盐酸戊乙奎醚（P组）和对照组（C组）,每组各20例。P组体外循环前10 m in颈内静脉注射盐酸戊乙奎醚0.05 mg/kg,对照组给予等容量生理盐水。分别于体外循环前（T1）、主动脉开放10 m in（T2）、停体外循环即刻（T3）、术后2 h（T4）、术后6 h（T5）、术后18 h（T6）采取中心静脉血标本,测定血浆I-FABP和血浆D-乳酸浓度。结果 T1时点两组患者血浆I-FABP和D-乳酸浓度的差异均无统计学意义（P〉0.05）;与C组比较,P组转流开始后及术后各时点血浆I-FABP浓度均降低,其中T2~T5时点与C组的差异有统计学意义（P〈0.05）;P组患者血浆D-乳酸浓度在转流后及术后各时点均较降低,其中T3、T4时点与C组的差异有统计学意义（P〈0.05）。结论预先给予盐酸戊乙奎醚0.05 mg/kg可降低围体外循环期患者血浆I-FABP和D-乳酸浓度,对肠黏膜屏障功能具有保护作用。OBJECTIVE To observe the effects of penehyclidine hydrochloride（PHC） on the concentration of blood intestinal type fatty acid-binding protein（I-FABP） and D-Lactate during cardiopulmonary bypass（CPB） in patients underwent open heart surgery.METHODS Forty patients underwent heart valve replacement with CPB were randomly divided into penehyclidine group（group P,20 cases） and control group（group C,20 cases）.Patients in group P were infused penehyclidine hydrochloride（PHC） 0.05 mg/kg at 10 min before CPB from the internal jugular vein： patients in group C were infused the same volume saline.Jugular vein blood samples was drawn at following 6 time points： before CPB（Tl）,10 min after aortic crossclamp release（T2）,immediately at the end of CPB（T3）,2 h after operation（T4）,6 h after operation（T5） and 18 h after operation（T6）.The concentration of blood I-FABP was measured by enzyme-linked immunosorbent assay.The concentration of D-Lactate was detected using spectrophotometer.RESULTS Comparing with the levels at T1,the concentrations of blood I-FABP and D-Lactate were all increased significantly at T2,T3,T4,T5 and T6（P0.05）.The peak values were measured at T5 for blood I-FABP and at T4 for D-Lactate.There were no significantly difference in the concentration of blood I-FABP and D-Lactate before CPB between the two groups（P0.05）.In group P,the concentration of blood I-FABP was significantly lower at T2,T3,T4 and T5 than those in group C（P0.05）.In group P,the concentrations of D-Lactate were significantly lower at T3 and T4 than those in group C（P0.05）.CONCLUSION 0.05 mg/kg PHC preconditioning before CPB can decrease blood I-FABP and D-Lactate concentration and has gut mucosal barrier protection effect.

关 键 词：盐酸戊乙奎醚 体外循环 肠黏膜屏障 肠型脂肪酸结合蛋白 D-乳酸 

分 类 号：R654.2[医药卫生—外科学]