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肺动脉灌注HTK液在法乐氏四联症矫治术中的肺保护作用(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第3期
页码:
379-382
栏目:
临床研究
出版日期:
2011-05-12

文章信息/Info

Title:
Lung perfusion with HTK solution relieves lung injury in corrections of Tetralogy of Fallot
作者:
李建安1刘迎龙2刘晋萍2李晓峰2
1.安徽医科大学附属安徽省立医院心脏外科,安徽 合肥 230001;2.北京协和医学院、中国医学科学院阜外医院儿童心脏外科中心,北京 100037
Author(s):
LI Jian-an1 LIU Ying-long2 LIU Jin-ping2 LI Xiao-feng2
1.Department of Cardiovascular Surgery, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui, China; 2.Pediatric Center of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing,
关键词:
肺损伤HTK液体外循环法乐氏四联症
Keywords:
lung injury HTK solution cardiopulmonary bypass
分类号:
R654.1
DOI:
-
文献标识码:
A
摘要:
目的:评价体外循环(CPB)中肺动脉灌注低温HTK液对法乐氏四联征(TOF)患儿肺的保护作用。方法: 选取TOF患儿24例,随机分为肺动脉灌注组(n=12)和对照组(n=12),计算各组氧合指数(OI)和肺泡-动脉氧分压差(AaDO2),硫代巴比妥酸反应法检测丙二醛(MDA)水平,ELISA法检测内皮素1(ET-1)、可溶性细胞间黏附分子-1(sICAM-1)和P-选择素水平。结果: 体外循环(CPB)后0、12、24、48 h,灌注组的OI均显著高于对照组(P<0.05,P<0.01),两组间变化的趋势有显著差异(P<0.05,P<0.01);灌注组的AaDO2均显著低于对照组(P<0.05,P<0.01);两组间CPB后MDA、ET-1、sICAM-1和P-选择素的水平变化趋势均有显著差异(P<0.05,P<0.01)。结论: CPB中肺动脉灌注低温HTK液可有效地减轻内皮细胞损伤,提高TOF矫治术后患儿的肺换气功能,改善预后。
Abstract:
AIM:To evaluate the protective effect of pulmonary perfusion with hypothermic HTK solution on lung function after cardiopulmonary bypass in corrections of tetralogy of Fallot. METHODS: Twenty-four consecutive infants with tetralogy of Fallot were randomly divided into perfusion group (n=12) and control group (n=12). Oxygen index, alveolar-arterial O2 gradient, serum levels of malondialdehyde, endothelin-1, sICAM-1, and P-selectin were measured before commencement and serially for 48 h after termination of bypass. RESULTS: Oxygenation values were better preserved in perfusion group than in control group. The trend revealed significant differences in serum levels of malondialdehyde, endothelin-1, sICAM-1, and P-selectin between groups. Serum levels of malondialdehyde, sICAM-1, and P-selectin tended to increase after bypass in control group, but remained at a low level in perfusion group. Serum levels of endothelin-1 increased significantly from 12 h after bypass in both groups and the levels in control group were significantly higher than those in perfusion group. CONCLUSIONS: This study suggests that pulmonary perfusion with hypothermic HTK solution during cardiopulmonary bypass relieves lung injury in infants with tetralogy of Fallot.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期:2010-04-06.基金项目:国家“十一五”计划基金资助课题(2004BA709B07) 通讯作者:刘迎龙,主任医师,主要从事心血管外科研究Email:jianan1993@sohu.com 作者简介:李建安,主治医师Email:yuesefu@msn.com
更新日期/Last Update: 2011-03-17