胎羊体外循环中血管内皮功能的变化对胎盘功能的影响  

The effects of the changes of endothelial function on the placental function during fetal lamb cardiopulmonary bypass

作　　者：周成斌[1] 苏肇伉[2] 张海波[2] 

机构地区：[1]广东省心血管研究所心外科,广州市510080 [2]上海第二医科大学附属新华医院,上海儿童医学中心胸心外科,上海市小儿先心病研究所,上海市200127

出　　处：《岭南心血管病杂志》2002年第1期52-55,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的　探讨胎羊体外循环中血管内皮功能的变化对胎盘功能的影响。方法　 8头胎羊 (体重 1 2kg±0 3kg)运用人工氧合器和滚轴泵建立体外循环 ,转流 6 0min。检测胎羊心率、血压、血气、联合心输出量和脐动脉流量 ,计算胎羊体循环阻力和胎盘血管阻力 ,测定胎羊血一氧化氮(NO)和内皮素 (ET - 1)含量的变化。结果　体外循环中胎羊心率、血压稳定 ;胎羊体循环阻力无显著性变化 ;胎盘血流减少 ,胎盘血管阻力明显增高 ,P <0 0 1。转流中胎羊血ET - 1急剧增高 ,NO增高缓慢。EF - 1/NO比值逐渐升高 ,与胎盘血管阻力呈正相关 ,P <0 0 5。转流后胎羊出现低氧、高碳酸血症和酸中毒。结论　胎羊体外循环损伤血管内皮功能 ,导致ET - 1/NO平衡失调 。Objective To study the effects of endothelial regulative mechanisms of vascular tone on the placental function during fetal lamb cardiopulmonary bypass. Methods Eight fetal lambs which weighted 1 2 kg± 0 3 kg had undergone cardiopulmonary bypass with artificial oxygenator and roller pump for one hour. Fetal heart rate, blood pressure, blood gases, combine cardiac output and umbilical artery flow were monitored. Systemic vascular resistance and placental vascular resistance were calculated. Serum endotheline (ET-1) and nitric oxide (NO) were assayed.Results Heart rate of fetal lamb and blood pressure were normal during bypass; oxygen tension and carbon oxide tension were maintained within fetal physiological levels. The systemic vascular resistance didn't change obviously. The placental vascular resistance elevated remarkably, P<0 01 . Serum ET-1 increased significantly and NO rise slowly, ratio of ET-1 and NO (ET-1/NO) elevated gradually. There were positive correlation between ET-1/NO value and placental vascular resistance, P<0 05 . After bypass, fetal lamb appeared hypoxia, hypercapnia and acidosis.Conclusion Fetal cardiopulmonary bypass deranges the endothelial regulative mechanisms of vascular tone and causes an imbalance of ET-1 and NO, which at last make the placental dysfunction.

关 键 词：胎羊体外循环 血管内皮 内皮素 一氧化氮 胎盘功能 胎儿心脏手术 动物实验 

分 类 号：R726.541[医药卫生—儿科]