体外循环围术期微量元素浓度变化的动态观察

目的：观察体外循环围手术期病人血清铜，锌，铁，镁，硒浓度的动态变化。方法：对36例先天性心脏病患者围手术期不同时相血清铜，锌，铁，镁，硒浓度进行测定，结果：血清铜在转流结束时最低，术后第二天恢复；血清锌在术后第一天降至最低，于术后第五天恢复，血清铁在术后早期升高，继而下降且较长时间不能恢复，血清镁在转流结束后降低，术后第三天恢复，血清硒术后降低明显，恢复较慢，结论：术前预防性地补充某些微量元素，可能有益于病人更好地耐受缺血再灌注损伤。

The dynamic change of serum levels of trace element during perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass

Objective To study the variour regulars of serum copper(Cu), zinc(Zn), iron(Fe), magnesium(Mg) and selenium(Se) during perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass(CPB). Methods The blood samples were taken from 36 patients at different time points during the period(prior to the operation; following weaning from CPB; 12 h after termination of CPB; at 24 h; and on the 3rd and 5th postoperative day). The serum levels of Cu, Zn, Fe, Mg and Se were determined. Trace elements analyses were performed using atomic absorption spectrophotometry and fluorospectrophotometry. Results The serum level of Cu was minimum at the end of CPB and returned to normal on postoperative day 2. Zn was minimum on postoperative day 1 and renewed on postoperative day 5. Fe increased early, then decreased and could not renew during long time. Mg decreased at the end of CPB and returned to normal on postoperative day 3. Se decreased significantly after operation and renewed slowly. The Cu/Zn ratio increased significantly during comparative long time after CPB. Conclusion Severe loss of various oligo elements occur in patients undergoing cardiac surgery with CPB. Supplementary administration of Zn, Mg and Se preoperatively seems to be appropriate for them to tolerate ischemical reperfusion injury.