高原浅低温体外循环心不停跳心内手术心肌保护与血浆CGRP变化关系的实验研究

目的　探讨血浆降钙基因相关肽 (CGRP)在高原条件下浅低温体外循环 (CPB)心不停跳心内手术过程中的变化及其于心肌保护作用中的临床意义。方法　选取手术治疗的 2 8例先天性心脏病患者分为体外循环组和非体外组 ,分别于术前、术中、术后各时相点采静脉血标本测定血浆心肌肌钙蛋白T (cTnT)和CGRP的含量。结果　非体外组血浆cTnT和CGRP含量于术前、术中、术后各时相点均无明显变化 ( P >0 .0 5 ) ,而体外组血浆cTnT含量在CPB5min后升高 ( P<0 .0 1) ,于术后 2h达到峰值 ,术后 2 4h仍然高于术前水平 ;血浆CGRP含量于CPB5min开始明显升高 (P <0 .0 1) ,并持续上升。结论　高原条件下采用浅低温体外循环心不停跳心内直视手术 ,血浆中舒张血管和心肌保护作用的CGRP浓度升高 ,有利于心肌保护、维护血液动力学稳定和防止心律失常。

Study of the relationship of plasma cgrp and myocardial protection on beating heart surgery with mild hypehtermic cardiopulmonary bypass on plateau

Objective To investigate plasma calcitonin gene-related peptide(CGRP)changes and the effect of myocardial protection on beating heart with mild hypothermic cardiopulmonary bypass(CPB)on Plateau.Methods 28 patients with congenital heart disease undergoing cardiac operations were enrolled into the study.Of them,20 patients were subjected as Group CPB,8 patients received ligation of PDA through thoracotomy as the control (group NB).Perioperative plasma Cardiac troponin T (cTnT) and CGRP were measured dynamically.Result There was no significant change of plasma cTnT,and CGRP in Group NB,which were significantly elevated in Group CPB.Conclusion The results suggest that the Myocardial Protection probably profited by stepping up of plasma CGRP on beating heart surgery with mild hypothermic cardiopulmonary bypass on plateau profits Myocardial Protection.