体外循环期间Apelin-36、NO和TNF-α的变化和意义  

Levels of Plasma Apelin-36,Nitric Oxide and Tumor Necrosis Factor-alpha during Cardiopulmonary Bypass in Patients with Cardiac Procedures

作　　者：吴德华[1] 张晓峰[1] 常昕[2] 徐凌峰[2] 张卫[3] 李欣[2] 徐美英[1] 

机构地区：[1]上海交通大学附属胸科医院麻醉科,上海200030 [2]上海交通大学附属胸科医院体外循环室,上海200030 [3]上海交通大学附属胸科医院心外科,上海200030

出　　处：《中国临床医学》2014年第5期531-533,共3页Chinese Journal of Clinical Medicine

基　　金：上海交通大学附属胸科医院科技发展基金(编号:YZ11-15)

摘　　要：目的:探讨体外循环期间Apelin-36、一氧化氮(NO)和肿瘤坏死因子-α(TNF-α)的变化和意义。方法:选择17例行直视下心脏手术患者,检测手术开始前(T0)、主动脉开放后即刻(T1)、主动脉开放后10 min(T2)、停机后即刻(T3)4个时间点动脉和静脉血浆中的Apelin-36、NO和TNF-α浓度。结果:与术前(T0)比较,体外循环过程中动脉血Apelin-36浓度在T1、T2和T3均升高(P<0.01或P<0.05);静脉血中Apelin-36浓度在T1和T2时高于T0(P<0.01);动脉血NO浓度在T1时、静脉血NO浓度在T3时高于术前值(P<0.01或P<0.05);动脉血TNF-α浓度在T1和T3以及静脉血TNF-α浓度在T3高于术前(P<0.01)。结论:体外循环可诱导血浆中Apelin-36、NO和TNF-α浓度的增加。Objective：To analyze the levels of plasma Apelin-36,nitric oxide （NO）and tumor necrosis factor-alpha （TNF-α） during cardiopulmonary bypass （CPB）in patients with cardiac surgery.Methods：Seventeen patients undergoing elective cardiac procedures with cardiopulmonary bypass were studied.The levels of arterial and venous plasma Apelin-36,NO and TNF-αwere measured by enzyme-linked immunosorbent assay at the following time points：before initiation of operation （T0）,imme-diately after aortic declamping （T1）,10 minutes after aortic declamping （T2）and the end of CPB （T3）.Results：Compared with T0,Apelin-36 levels in arterial plasma elevated at three time points of T1,T2 and T3 （P 〈0.01 or P 〈0.05）and in ve-nous plasma elevated at two points of T1 and T2（P 〈0.01）.The arterial plasma NO levels elevated at the time point of T1 and the venous NO levels elevated at the time point of T3（P 〈0.01 or P 〈0.05）.The arterial plasma TNF-αlevels elevated at two time points of T1 and T3（P 〈0.01）,and elevated in venous plasma at the time point of T3（P 〈0.01）.Conclusions：CPB can increase the levels of plasma Apelin-36,NO and TNF-α.

关 键 词：体外循环 APELIN 一氧化氮 肿瘤坏死因子-Α 

分 类 号：R654.1[医药卫生—外科学]