卵圆孔单向活瓣术对室缺伴重度肺高压患者术后早期ET-1表达影响的研究  

Effect of foramen ovale unidrectional valved pacth on the expression of ET-1 at the early stage post-surgery in VSD patients with severe PAH

作　　者：邓明彬[1] 付勇[1] 廖斌[1] 于风旭[1] 方易冰[1] Deng Mingbin Fu Yong Liao Bin Yuan Fengxu Fang Yibing(Department of Thoracic Surger, the Affiliated Hospital of Southwest Medical Universty, Luzhou, Sichuan Province, 646000, Chin)

机构地区：[1]西南大学附属医院胸心外科,四川泸州646000

出　　处：《泸州医学院学报》2016年第6期516-519,共4页Journal of Luzhou Medical College

基　　金：泸州市科技局基金资助项目(编号:2011-S-16(4/4))

摘　　要：目的:室缺肺高压患者行修补术,术中应用卵圆孔单向活瓣进行手术,探讨该手术方式对室缺肺高压患者术后早期ET-1的影响。方法 :将同期患先心病室间隔缺损患者,经行心脏彩超评估为中重度肺动脉高压患者18例,体外循环下行室间隔缺损修补手术,按术中是否采用卵圆孔单向活瓣手术,将患者分为单向活瓣组(n=11)和常规手术组(n=7),术前、术后2 h、4h、8 h、16 h、24 h、术后3 d应用酶免法进行血清ET-1检测。结果 :两组患者术前一般资料差异无统计学意义;单向活瓣手术组血清ET-1比较,术前与术后各组比较差异均具有统计学差异;常规手术组血清ET-1比较,术前与术后24 h、术后3 d比较差异具有统计学差异;单向活瓣组和常规手术组各时点血清ET-1比较差异无统计学意义。两组患者均有1例术后死亡。结论:室间隔缺损并肺高压患者行卵圆孔单向活瓣术,术后早期血清ET-1表达即明显降低,且较常规手术组改善早。该手术方法可能对缓解术后早期肺动脉高压危象发生有一定帮助。Objective： To evaluate the effect of foramen ovale unidrectional valved pacth on the expression of ET-1 at the early stage post-surgery in ~SD patients with severe PAH. Methods： Eighteen cases of VSD patients with the severe PAH assessed by echocardiography were divided into two groups, unidrectional valved pacth group （n = 11） and the conventional surgery group （n = 7）. All cases were repaired under cardiopulmonary bypass. Serum ET-1 of all cases were analyzed prior to operation and at 2 h, 4 h, 8 h, 16 h, 24 h, and 3 d post-operation using enzyme immunoassay. Data were analysed using SPSS17.0 software, and P 〈 0.05 was considered statistically significant. Results： There were no significant differences between the two groups in terms of demographic information. There were significant differences of the levels of plasma ET-1 between pre-operation and postoperation at 2 h, 4 h, 8 h, 16 h, 24 h, and 3 d in the Unidrectional Valved Pacth group, and between pre-operation and postoperation at 24 h and 3 d in the conventional surgery group. There were no significant differences of the plasma ET-1 between the two groups. One patient was dead after operation in each group. Conclusion： Postoperative plasma ET-1 expression was markedly reduced in the unidrectional valved pacth group, and the reduction happened earlier than the conventional surgery group, indicating unidrectional valved pacth maybe good to reduce the occurrence of PAH crisis at the early stage post-operation.

关 键 词：单向活瓣 室间隔缺损 肺动脉高压 ET-1 

分 类 号：R654.2[医药卫生—外科学]