先心病合并重度肺动脉高压围术期体液因素对肺损伤的影响

目的 :探讨先心病合并重度肺动脉高压围术期体液因素对肺损伤的作用机制。方法 :2 0 0 0年 1月至 2 0 0 1年 2月 ,连续对 31例先天性心脏病室间隔缺损 (非肺动脉高压 16例 ,重度肺动脉高压 15例 )直视修补术患者分组进行临床研究 ,在围术期对血栓素B2 (TXB2 )和 6 酮 前列腺素F1α(6 keto PGF1α)、丙二醛 (MDA)、IL 6、IL 8的变化进行研究 ,并结合体外循环前、后肺动脉压、全肺阻力变化进行分析。结果 :围术期TXB2 、6 keto PGF1α与TXB2 的比值 (P T)、MDA、IL 6、IL 8的变化与围术期肺动脉压、全肺阻力、呼吸指数的改变有着密切相关。结论 :在围术期先心病合并重度肺动脉高压组的体液因素变化较非肺动脉高压患者剧烈 ,易发生肺损伤 ,围术期肺动脉高压危象是肺损伤在血液动力学方面的表现

The relation of the humoral factor and lung injury during perioperation of congenital heart disease with severe pulmonary hypertension

Objective:To investigate the mechanism of the humoral factor effecting on lung injury during perioperation of congenital heart disease with severe pulmonary hypertension.Method:Thirty\|one consecutive cases of congenital heart disease with ventricular septal defect (no pulmonary hypertension 16 case,severe pulmonary hypertension 15 case)were studied during perioperation from January 2000 to February 2001.TXB\-2,6\|keto\|PGF 1α ,MDA,IL\|6,IL\|8 and leukocyte number were measured during perioperation.Mean pulmonary arterial pressure,pulmonary vascular resistance was analyzed before and after cardiopulmonary bypass.Result:TXB\-2,6\|keto\|PGF\-\{1α\} compared with TXB\-2(P/T),MDA,IL\|6,IL\|8 and leukocyte number were closely related to pulmonary pressure,pulmonary vascular resistance and respiration index(RI) in the case of congenital heart disease with severe pulmonary hypertension during perioperation.Conclusion:The humoral factor of the cases of congenital heart disease with pulmonary hypertension changed significantly during perioperation,leaded easily to pulmonary damage.The pulmonary hypertensive crisis during perioperation showed the result of lung injury in hemodynamics.