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血浆内皮素-1水平在先天性心脏病体外循环围手术期的动态变化及临床意义
引用本文:晋炳申,王军,郑建伟,郭良玉,王玮. 血浆内皮素-1水平在先天性心脏病体外循环围手术期的动态变化及临床意义[J]. 潍坊医学院学报, 1998, 0(1)
作者姓名:晋炳申  王军  郑建伟  郭良玉  王玮
作者单位:潍坊市人民医院
摘    要:
目的观察血浆内皮素-1水平在先天性心脏病体外循环围手术期的动态变化。方法对20例先天性心脏病在体外循环围手术期内皮素(ET-1),血栓素A2(TXA2),前列环素(PGI2)进行动态监测。结果①患者术前动脉血ET-1水平高于静脉血ET-1水平,但差异不显著(P>0.05),术后2周动脉血ET-1水平低于静脉血ET-1水平,且差异显著(P<0.05)。②血浆ET-1水平在体外循环(CPB)期间持续上升,并在CPB结束时达到峰值,峰值与CPB持续时间和CPB结束时血浆TXA2而与体外循环期间尿量呈负相关。③在整个围术期和CPB期间,血浆ET-1水平均与血浆TXA2水平呈正相关。结论①肺循环异常时,肺脏对ET的清除能力下降,动、静脉ET-1水平的差值可作为先天性心脏病体外循环术后肺循环改善的一项指标。②显著增高的ET-1可能与长时间CPB后的心肾功能障碍有关。③TXA2对先天性心脏病体外循环围术期间的血浆ET-1变化起重要作用

关 键 词:先天性心脏病;体外循环;内皮素

THE DYNAMIC CHANGE OF PLASMA ENDOTHELIN 1 DURING THE PERIOPERATIVE PERIOD IN PATIENTS WITH CONGENITAL HEART DISEASE AND ITS CLINICAL SIGNIFICANCE
Jin Bingshen,Wang Jun,Zheng Jianwei,et al Weifang People's Hospitsl,Weifang. THE DYNAMIC CHANGE OF PLASMA ENDOTHELIN 1 DURING THE PERIOPERATIVE PERIOD IN PATIENTS WITH CONGENITAL HEART DISEASE AND ITS CLINICAL SIGNIFICANCE[J]. Journal of Weifang Medical College, 1998, 0(1)
Authors:Jin Bingshen  Wang Jun  Zheng Jianwei  et al Weifang People's Hospitsl  Weifang
Affiliation:Jin Bingshen,Wang Jun,Zheng Jianwei,et al Weifang People's Hospitsl,Weifang,261042
Abstract:
Objective To observe the dynamic change of plasma endothelin 1 during the perioperative period in patients with congenital heart disease.Methord The blood samples were taken for determination of endothelin 1.(ET 1) thromboxane A 2(TXA 2) Prostacylin (PGI 2) pre ,intra and postoperatively.Result Before the operation,the venous ET 1 level was a little lower than the arterial level,but the differences did not reach statistical significance. After the operation,the arterial ET 1 level gradually began to decline to a lower level than the venous ET 1 level,but the differences between the arterial ET level and the venous ET 1 level did not reach statistical significance until two weeks after the operation. The plasma ET 1 concentration was also significantly increased during the course of cardiopulmonary bypass(CPB)and peaked at the end of CPB. The maximal ET 1 level correlated positively with the duration of CPB and the plasma TXA 2 concentration at the end of CPB, but negatively with the urine volume during CPB. The plasma ET 1 concentration correlated positively with the plasma TXA 2 concentration both during the perioperative period and during the CPB.Conculsion (1)When pulmonary hemodynamics is abnormal,the pulmonary ability to eliminate ET declines. The differences between the arterial ET 1 level and venous ET 1 level might be considered an indicator for the improvement of pulmonary hemodynamics in congenital heart disease after operation.(2)The markedly elevated plasma ET 1 can possibly be associated with cardiac or renal dysfunction after prolonged CPB.(3)TXA2 might play an important role in the dynamic change of plasma ET 1 levels.
Keywords:congenital heart disease  cardiopulmonary by pass  Endothelin
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