小儿体外循环期间钙、镁及甲状旁腺激素的动态变化  

Kinetic changes of calcium,magnesium and parathyroid hormone in children during cardiopulmonary bypass

作　　者：任同悦[1] 陈健[1] 杨晓伟[2] 

机构地区：[1]天津市第四中心医院麻醉科,天津300140 [2]天津市胸科医院麻醉科,天津300152

出　　处：《中国心血管杂志》2003年第2期93-95,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的　观察小儿体外循环期间钙、镁及甲状旁腺激素 ( PTH)的变化。方法　静脉血标本取自 3 0例心内直视手术患儿 ,采用原子吸收光谱法、离子选择电极法及化学发光分析方法 ,于体外循环期间不同时间点检测总钙、离子钙、总镁及 PTH的含量。结果　在体外循环开始后钙、镁及 PTH均降低 ( P<0 .0 5 ) ,至体外循环结束时降至最低点 ( P<0 .0 1)。钙离子于术后第 1天回复至术前水平 ,而总钙及总镁含量于术后第一天仍低于术前水平 ( P<0 .0 5 )。 PTH于体外循环后 2 h升高 ,至术后第 1天升至术前的 2 .6倍 ( P<0 .0 1)。结论　小儿体外循环期间发生了明显的低钙、低镁血症。钙 -镁 -甲状旁腺轴反应基本正常 。Objective To observe the changes of calcium, magnesium and parathyroid hormone (PTH)during cardiopulmonary bypass(CPB). Methods Venous blood samples were withdrew from 30 patients undergoning selective open-heart surgery.The concentration of total calcium (CaT),total magnesium (MgT),ion calcium (CaI)and PTH was detected by atomic absorption spectroscopy ,ion-selective electrodes and two-site chemiluminescent immunometric assay at multiple time points during CPB.Results The concentration of CaT,CaI,MgT and PTH was markedly decreased at the beginning of CPB(P<0.05),and reached their nadirs by the end of CPB(P<0.01).CaI returned to its preoperative level on the first postoperative day (P<0.05).PTH elevated at 2 hours after the termination of CPB,to 2.6 times as much as the preoperative level on the first postoperative day (P<0.01). Conclusion Hypocalcemia and hypomagnesemia occurred during CPB.The calcium-magnesium-PTH axis responded normally,but showed hysteresis.

关 键 词：钙 镁 甲状旁腺激素 体外循环 小儿 

分 类 号：R726.5[医药卫生—儿科]