胎羊体外循环中的应激反应  

The stress reaction in fetal lamb under fetal cardiopulmonary bypass

作　　者：苏肇伉[1] 周成斌[1] 

机构地区：[1]上海第二医科大学附属新华医院

出　　处：《上海医学》2002年第6期360-362,T003,共4页Shanghai Medical Journal

基　　金：国家自然科学基金项目 (3 9770 73 4)

摘　　要：目的　研究胎羊体外循环中胎羊的应激反应。方法　 6头孕羊运用人工氧合器和滚轴泵建立胎羊体外循环模型 ,转流 30min ,转流中胎羊血气值维持在生理水平。监测胎羊血压、心率、血气和乳酸值 ,测定转流前和转流 30min胎羊儿茶酚胺、皮质醇和胰岛素水平 ;连续监测胎羊血糖和游离脂肪酸的变化 ;胎羊肝脏组织PAS染色。结果　转流中胎羊血压、心率、血气值与转流前无差别 ,但出现代谢性酸中毒 ;胎羊儿茶酚胺和皮质醇含量明显增高 (P <0 .0 1) ,胰岛素含量无明显变化 ;血糖和游离脂肪酸在转流初期升高 (P <0 .0 5 ) ,随着转流时间延长 ,血糖和游离脂肪酸含量下降 ,与转流前无差别 ;胎羊肝脏PAS染色显示肝脏糖原大量消耗。转流30min停循环 ,胎羊存活时间不超过 1h。Objective To study the stress reaction of fetal lamb under fetal cardiopulmonary bypass. Methods Six ewes between 116 and 135 day's gestation had undergone fetal cardiopulmonary bypass with artificial oxygenator and roller pump for 30min, in which blood gas value was maintained at the physiological level. The fetal blood pressure, heart rate, pH value and blood lactate were monitored during the bypass. The level of blood catecholamine, cortisol and insulin pre bypass and bypass for 30 min were assayed. The blood sugar and free fatty acid were monitored subsequently and the fetal hepatic PAS staining was made.Results There were no difference in fetal blood pressure, heart rate, blood gas before and during bypass, but pH value decreased progressively with which statistical significance appeared at bypass for 30 min( P <0.05). The blood lactate elevated significantly at bypass for 10 min( P <0.01). The blood catecholamine and cortisol increased greatly( P <0.01). There was no change in insulin level. The blood sugar and free fatty acid elevated at the beginning of bypass( P <0.05), and then slowed down gradually with the bypass. There was no difference between the pre bypass and 30 min bypass. The fetal hepatic PAS staining showed great consumption of hepatic glycogen. After 30 min bypass, the fetal lamb could not survive more than 1 hour.Conclusion The fetal stress under fetal cardiopulmonary bypass is harmful to survival of the fetal lamb.

关 键 词：胎羊 体外循环 应激反应 动物实验 

分 类 号：R714.5[医药卫生—妇产科学]