体外循环手术中肺脏内皮素-1的变化  

Cardiopulmonary Bypass Increase Endothelin-1 Production in the Lung

作　　者：晋炳申[1] 姚忠喜[1] 高百顺[1] 李天成[1] 高秉仁[1] 陈春红[1] 

机构地区：[1]兰州医学院第一附属医院心外科,甘肃省兰州市730000

出　　处：《中国循环杂志》2000年第2期108-109,共2页Chinese Circulation Journal

摘　　要：目的：证实体外循环（ＣＰＢ）手术中是否出现肺脏内皮素－１（ＥＴ－１）增加。 方法：１８例心脏病患者，于主动脉阻断前即刻，主动脉开放后心脏复跳１、３、５分分别取肺静脉血和右心房血。主动脉开放前约１分持续膨胀肺，取肺静脉血和氧合器内血，测定血浆ＥＴ－ｌ含量。 结果：主动脉阻断前即刻，主动脉开放后心脏复跳３、５分，肺静脉血与右心房血ＥＴ－１水平无显著差异（Ｐ＞０．０５）；心脏复跳１分肺静脉血ＥＴ－１水平显著高于右心房血（Ｐ＜０．０５）；主动脉开放前约１分，肺静脉血ＥＴ－１水平显著高于主动脉阻断前以及同时点氧合器内血ＥＴ－１水平（Ｐ＜０．０５）。 结论：ＣＰＢ手术导致肺脏出现病理性ＥＴ－１增加，这可能与ＣＰＢ肺脏损伤及术后肺动脉压升高有关。Objective:To investigate whether cardiopulmonary bypass increases endothelin-1 (ET-1) production in the lung. Methods:We measured ET-1 levels in blood samples from pulmonary vein,right artrium(right before aortic cross- clamping,at aortic opening, 1 min, 3 min and 5 min after heart beating)and pulmonary vein,oxygennater (continuously inflating the lung for 1 min before opening). Results:There were no significant differrences in ET-1 levels between pulmonary vein and right artrium (right be- fore aortic crossclamping,aortic opening, 3 min and 5 min after heart beating, p> 0. 05). ET-1 level in pulmonary vein was significantly higher than that of right artrium at 1 min after heart beating(p<0.05). At 1 min before aortic open- ing,ET-1 level in pulmonary vein was significantly higher than that from before aortic crossclamping and that of oxy- genater at the same time. Conclusion:Cardiopulmonary bypass induces pathological increase of ET-1 level in the lung,which could relate to pulmonary injury after cardiopulmonary bypass and posoperative pulmonary hypertension.

关 键 词：体外循环 手术中 内皮素-1 肺脏 

分 类 号：R654.1[医药卫生—外科学]