升主动脉注射鱼精蛋白对体外循环心脏直视手术婴儿肺通透性指数及血浆血栓素A2浓度的影响

目的探讨经升主动脉注射鱼精蛋白对体外循环心脏直视手术婴儿肺通透性指数及血清血栓素A2浓度的影响,进一步证实其肺保护作用。方法选择60例（年龄≤12个月,体质量≤10 kg）在深圳市儿童医院行体外循环心脏直视手术的先天性心脏病患儿,按随机数字表法分为实验组（升主动脉组,n=30例）和对照组（中心静脉组,n=30例）,比较两组体外循环前及注射鱼精蛋白后6 h肺通透性指数的变化、体外循环前及注射鱼精蛋白后1 h血清血栓素A2浓度。结果实验组注射鱼精蛋白6 h后肺通透性指数明显低于对照组,差异有统计学差异（0.021±0.008 vs.0.039±0.006,P〈0.05）;实验组注射鱼精蛋白1 h后血清血栓素A2水平低于对照组,差异有统计学意义[（43.3±2.5）ng/L vs.（64.2±2.1）ng/L,P〈0.05]。结论经升主动脉注射鱼精蛋白能够减轻婴幼儿体外循环心脏直视手术肺组织损伤,是一种良好的肺保护措施。

Effects of intraaortic protamine on lung permeability index and plasma level of thromboxane A2 in infants during open heart operation by cardiopulmonary bypass

Objectives To observe the effects of intraaortic protamine on lung permeability index and thromboxane A2 （TXA2） level in infants during open heart operation by cardiopulmonary bypass, and to prove its protective function for lung. Methods Totally 60 infants （age ≤ 12 months,weight ≤ 10 kg） undergone open heart operation by cardiopulmonary bypass in Shenzhen Children＇s Hospital were randomized into intraaortic protamine group （test group, n=30） and intravenous protamine group （control group, n=30）. Lung permeability indexes were compared between test group and control group before cardiopulmonary bypass and 6 hours after injecting protamine. Plasma levels of TXA2 were compared between test group and control group before cardiopulmonary bypass and f hour after injecting protamine. Results Lung permeability index of test group was markedly lower compared with that of control group 6 hours after injecting protamine （0.021±0.008 vs.0.039±0.006,P〈0.05）. Plasma level of TXA2 of test group was markedly lower compared with that of control group 1 hour after injecting protamine [ （43.3±2.5）ng/L vs. （64.2±2.1）ng/L, P〈0.05 ]. Conclusions Intraaortic protamine is a good way for lung protection as it decreases lung tissue injury, in infants during open heart operation by cardiopulmonary bypass.