体外循环期间血浆一氧化氮浓度变化  

The changes of serum NO concentration during cardiopulmonary bypass

作　　者：马支媛[1] 王俊科[1] 孙新艳[1] 李庆梅[1] 

机构地区：[1]中国医科大学第一附属医院麻醉科,沈阳市110001

出　　处：《临床麻醉学杂志》2001年第8期422-423,共2页Journal of Clinical Anesthesiology

摘　　要：目的　吸入一氧化氮 (NO)应用于心内直视手术治疗肺动脉高压取得较好作用 ,感染性休克病人血浆NO浓度明显升高 ,但心肺转流 (CPB)期间血浆NO浓度变化报道尚少。本文测定了CPB期间及停机后血浆NO浓度的变化 ,旨在为临床应用NO治疗提供参考。方法　分别在手术前、CPB10分钟、停机前及停机后 1、6、12小时和 2 4小时测量血浆NO浓度。结果　术前血浆NO平均值 ( 2 73± 0 67) μmol/L ,而CPB后 10分钟、停机前及停机后 1、6、12小时和 2 4小时分别为 ( 3 80± 1 61)、( 4 0 9± 1 3 0 )、( 3 97± 1 18)、( 3 80± 1 3 1)、( 3 69± 1 0 2 )和 ( 3 4 1± 1 2 1) μmol/L。停机前达最高值 ;停机后浓度有所降低 ,但均较术前值显著升高 (P <0 0 0 0 1) ;术后 2 4小时仍高于术前。结论　CPB可导致血浆NO浓度显著升高 ,且持续至停止CPB后 2 4小时。CPB降温和复温过程对NO有影响 ,复温期NO浓度达最高值。NO浓度升高可能与CPB过程中的全身炎症反应有关。Objective NO inhalation has been used successfully in the treatment of pulmonary hypertension during cardiac surgery.Serum NO concentration is increased remarkably in patients with infective shock,but the changes of it were seldom reported during cardiopulmonary bypass (CPB).In this study,we measured the serum NO concentration during and after CPB.Methods To measure the serum NO concentration before CPB,at 10min and the end of CPB,and 1h after CPB.Results Serum NO concentration was (2 73±0 61)μmol/L preoperatively,which was significantly increased to (3 80±1 61)μmol/Lat 10min after the beginning of CPB, (4 09±1 30)μmol/L at the end CPB,(3 97±1 18)?(3 80±1 31)?(3 69±1 02) and (3 41±1 21)μmol/L at 1h,6h,12h and 24h after CPB respectively( P< 0 001).Conclusion CPB could lead to a significant increase of serum NO till 24h after CPB,which was influenced by hypothermia and rewarming.The changes may be related to the systemic inflammatory response during CPB.

关 键 词：心肺转流 一氧化氮 体外循环期间 血浆 浓度变化 

分 类 号：R654.1[医药卫生—外科学]