吸入NO对婴幼儿体外循环中肺表面活性物质的影响

目的: 探讨吸入一氧化氮(NO)对婴幼儿体外循环（cardiopulmonary bypass，CPB）中肺表面活性物质的影响。 方法: 将30例患室间隔缺损的婴幼儿随机分为对照组和NO组，NO组在CPB期间吸入40 μl/L NO直至关胸。CPB前、主动脉开放后1，5，10 min以少量生理盐水灌洗气道，分别测定气道吸出物(BAL)中总磷脂(TPL)、饱和卵磷脂(SatPC)、总蛋白(TP)值，并计算SatPC/TPL和SatPC/TP。结果: CPB后两组SatPC/TPL、SatPC/TP较CPB前明显降低(P<0.01)。NO组SatPC/TPL和SatPC/TP下降的幅度明显小于对照组(P<0.01)。结论: 婴幼儿CPB术中存在明显的肺损害，表现为一些亚临床性肺功能损伤。吸入40 μl/L的NO对CPB期间肺功能有明显的保护作用。

Effects of inhaled nitric oxide on pulmonary surfactant during cardiopulmonary bypass in infants

AIM: To study the effects of inhaled Nitric Oxide (NO) on pulmonary function and pulmonary surfactant during cardiopulmonary bypass in infants. METHODS: Thirty infants with congenital heart disease with the high degree of PH were randomly divided into two groups: control group (n=15) and NO group (n=15). From throughout the cardiopulmonary bypass（CPB）, 40 μl/L NO was inhaled in NO group. Before CPB and at 1, 5 and 10 min after aortic declamping, air tube was lavaged by small amounts of normal saline, the levels of TPL, SatPC and TP were determined and the values of SatPC/TPL and SatPC/TP were calculated. RESULTS: The levels of SatPC/TPL and SatPC/TP post-operation were lower than those before CPB (P<0.01) and the decreased formants of SatPC/TPL and SatPC/TP in control group were higher than those in NO group. CONCLUSION: Lung ischemia-reperfusion injury is obvious during CPB in infants and manifests as sub-clinical pulmonary function injury. Inhale 40 μl/L NO has marked protective effect on the lung function during CPB.