心脏不停跳心内直视手术血浆S-100b及脑电图的对照研究  

Study the changes of S-100b in plasma and EEG in on-pump beating-heart intracardiac procedure with mild hypothermia

作　　者：王咏[1] 肖颖彬[1] 陈林[1] 钟前进[1] 王学锋[1] 刘梅[1] 

机构地区：[1]第三军医大学新桥医院心血管外科,重庆400037

出　　处：《重庆医学》2003年第12期1673-1675,共3页Chongqing medicine

摘　　要：目的　观察和研究血浆中S 1 0 0b蛋白及脑电图 (EEG)在浅低温体外循环 (CPB)心脏不停跳心内直视手术围手术期的变化。方法　选择接受择期心内直视手术的先天性心脏病患者 2 0例 ,在浅低温体外循环心脏不停跳下施行手术 ,所有患者在术前 (a点 ) ,CPB开始后 2 0min(b点 ) ,CPB结束后 6 0min(c点 )和术后 1d(d点 )及术后 7d(e点 )采取血样本。运用酶联免疫吸附法 (单克隆双抗体夹心法 )测定血浆中S 1 0 0b蛋白含量。所有患者术前与术后 1、7d进行脑电图检查。结果　CPB开始后 2 0min所有患者血浆中的S 1 0 0b均明显升高 ,而且一直持续到术后 1d仍高于术前水平 (P <0 .0 1 ) ;术后 7d恢复至术前水平 (P >0 .0 5 )。术前所有患者EEG均正常 ,术后 1d患者EEG的异常率为 90 % ;术后 7dEEG异常率为 6 5 %。结论　浅低温体外循环心脏不停跳心内直视手术会造成一定程度的脑组织损伤。S 1 0 0b和EEG从不同方面反映了脑组织在心内直视手术中所受的影响 。Objective To observe the changes of S 100b in plasma and EEG in on pump beating heart intracardiac procedure with mild hypothermia.Methods Twenty patients with congenital heart disease underwent in on pump beating heart intracardiac procedures with mild hypothermia.We collected arterial blood samples at preoperation(time a),CPB twenty minutes(time b),one hour after CPB (time c),one day after operation(time d) and 7days after operation(time e).Levels of plasma protein S 100b were measured with ELISA.All patients were checked with EEG before,one day and seven days after operation.Results The levels of plasma protein S 100b increased significantly at time b,c and d( P <0.01).At the time e,the levels of S 100b returned to the nadir.The postoperative EEG abnormality rates were 90% in one day after operation and 65% in seven days after operation.Conclusion The on pump beating heart intracardiac procedures could make some cerebral injury.S 100b and EEG are important methods in finding and assessing the cerebral injury in on pump beating heart intrardiac procedure.

关 键 词：心脏不停跣心内直视手术 S-100B蛋白 体外循环 脑损伤 脑电图 

分 类 号：R654.2[医药卫生—外科学]