婴幼儿体外循环期间尿液氨甲环酸浓度的研究  

Urine concentration of tranexamic acid during cardiopulmonary bypass in infants

作　　者：文仁国[1] 齐萍 彭晓波[1] 马瑞岩[1] 孙国林[1] 

机构地区：[1]第三军医大学新桥医院心外科,重庆400037 [2]青岛儿童医院麻醉科,山东青岛266011

出　　处：《局解手术学杂志》2013年第5期472-474,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的应用核磁共振波谱研究婴幼儿法洛四联症根治术体外循环期间尿液氨甲环酸浓度及排泄率。方法 5例先天性法洛四联症患儿,年龄(11±6.3)月,体质量(7.36±2.08)kg,在开胸前应用氨甲环酸100 mg/kg,单次静脉缓慢注射(注射时间10 min以上),体外循环开始前再次注射100 mg/kg。应用核磁共振波谱方法,检测不同时间段尿液氨甲环酸浓度。结果体外循环开始前、体外循环期间、关胸期间的尿液氨甲环酸浓度分别为(5.03±2.93)、(4.85±2.68)、(3.48±2.24)mg/mL。体外循环开始前、体外循环期间、关胸期间氨甲环酸量分别为(199.7±142.1)、(341.6±302.3)、(400.1±357.0)mg。至手术结束(用药后约3 h)氨甲环酸排泄量为(57.48±19.66)%。体外循环开始前排泄率为(6.5±4.8)mg/min,体外循环期间排泄率为(4.5±4.9)mg/min,关胸期间排泄率为(13.1±9.6)mg/min,总排泄率为(6.2±3.4)mg/min,各时间段均无显著性差异,P>0.05。氨甲环酸在0.03～6.0 mg/mL具有良好的线性关系(r=0.996);平均回收率为99.6%,相对标准差为0.39%(n=6)。结论核磁共振波谱能够检测出尿液氨甲环酸的浓度。该法灵敏、准确、迅速、重复性好、尿样品处理方法简单。Objective To study the urine concentration of tranexamic acid during cardiopulmonary bypass in infants with tetralogy of Fallot detected by 1H-nuclear magnetic resonance spectrum. Methods Five infants with tetralogy of Fallot injected slowly with an initial dose of 100 mg/kg of tranexamic acid by the intravenous route for over 10 minutes and received another dose of 100 mg/kg tranexamic acid before the initiation of cardiopulmonary bypass. Tranexamic acid in urine was measured by l H-nuclear magnetic resonance spectrum. Results Urine tranexamic acid concentrations before cardiopulmonary bypass, during cardiopulmonary bypass and sternal closure were respectively （ 5.03 ± 2.93 ） mg/mL, （ 4.85 ± 2.68 ） mg/mL, （ 3.48 ± 2.24 ） mg/mL. Total volume of tranexamie acid in urine before cardiopulmonary by- pass, during cardiopulmonary bypass and sternal closure were respectively（ 199.7±142.1 ） mg, （ 341.6 ± 302.3 ） mg, （ 400.1 ± 357.0 ） mg. The rate of tranexamic acid excretion were（57.48 ± 19.66） % by the end of operation. The excretion rate of tranexamic acid before cardiopul- monary bypass, during cardiopulmonary bypass and sternal closure were respectively （ 6.5 ± 4.8 ） mg/min, （ 4.5± 4.9） mg/min, （ 13.1 ± 9.6 ） mg/min . The total excretion rate was （ 6.2± 3.4 ） mg/min. There was a linear relationship when volume of tranexamic acid was 0.03 6.0 mg/mL（ r =0.996）. The average recovery rate was 99.6% ,relative standard deviation was 0.39% （ n =6）. Conclusion This is an accurate, sensitive, specific and convenient method, which can be used for the determination of tranexamie acid in urine.

关 键 词：氨甲环酸 婴幼儿 核磁共振波谱 尿液 体外循环 

分 类 号：R654.1[医药卫生—外科学] R969.1[医药卫生—临床医学]