银杏叶提取物对心脏围手术期患者血管内皮生长因子的影响

目的 探讨银杏叶提取物(金纳多)心停跳液对围手术期血浆血管内皮生长因子(VEGF)水平的影响及其临床意义。 方法 20例心脏手术患者采用数字表法随机均分为两组，对照组(10例)常规建立体外循环(CPB)，阻断升主动脉后经主动脉根部顺灌4 ℃ St Thomas′停搏液(15 mL/kg)；银杏叶组(10例)：在4 ℃ St Thomas′停搏液中加入金纳多（0.5 mg/kg），余同对照组。麻醉诱导前后、主动脉插管后转机前、主动脉阻断0.5 h、主动脉开放0.5 h、术毕即刻、术后6 h、术后24 h分别取桡动脉血2 mL采用酶联免疫吸附法(ELISA)测定VEGF浓度。 结果 对照组VEGF浓度在主动脉阻断0.5 h开始上升，术后6 h达到高峰(P<0.01)；银杏叶组在主动脉阻断0.5 h时已达高峰(P<0.01)，主动脉开放0.5 h时开始下降。 结论 金纳多可诱导VEGF生成，这可能是其心肌保护的机制之一。

Effect of Ginkgo Biloba Extract on Plasma Vascular Endothelial Growth Factor during Peri-operative Period of Cardiac Surgery

Objective To investigate the effect and clinical value of ginkgo biloba extract （Ginaton） on the plasma vascular endothelial growth factor （VEGF） in patients during peri-operative period of cardiac surgery. Methods Twenty patients scheduled to receive cardiac operation were randomly assigned to 2 groups by a digital table. For the 10 patients in the control group, the cardiopulmonary bypass （CPB） was established in routine and received cold （4℃） St Thomas＇ cardioplegia perfusion （15 mL/kg） via aortic root after ascending aorta blocking, as for the 10 patients in the Ginaton group, the same was done but with 0.5 mg/kg of Ginaton added to the cardioplegia perfusion. Plasma VEGF contents were detected by ELISA at different time points, i.e. before and after anesthesia induction （T1 , T2） , after aorta intubation （T3） , 0.5 h after aorta clamping （T4） , 0.5 h after aorta declamping （T5）, immediate after terminating the operation （T6） , 6 h after operation （T7） , and 24 h after operation （ T8 ）. Results In the control group, VEGF level began to rise at T4 and reached the peak at T7 （ P 〈0.01 ）, while in the Ginaton group, it reached the peak early at T4（P〈0.01 ）, and began to drop at Ts（ P〈 0.01 ）. Couclusiou Ginaton could induce the production of VEGF, which may be one of the mechanisms for its myocardial protection.