迷宫手术后血浆心房钠尿肽的变化及其临床意义

The change of plasma atrial natriuretic peptide after maze operation and its clinical implication

目的：了解迷宫手术后早期心房钠尿肽（ＡＮＰ）的变化及其临床意义。方法：选择我院行迷宫手术＋二尖瓣替换术及同期双瓣置换各８例，分别于术前晚，术后当日，术后１，３，７ｄ抽取周围静脉血４ｍｌ，用放免方法测定血浆中ＡＮＰ含量，同时用Ｓｗａｎ－Ｇａｎｚ导管测定心排量，中心静脉压。并将两组体外循环时间进行比较。结果：迷宫手术后当日及第１天ＡＮＰ明显降低，第３，７天开始回升，但仍未达到术前水平。结论：迷宫手术后早期，ＡＮＰ因左右心耳被切除，手术创伤及缺血再灌注损伤而处于较低水平，提示迷宫术后早期应加大利尿剂用量。

Objective: To study the change of plasma atrial natriuretic peptide (ANP) after modified Cox's maze operation. Methods: The levels of ANP before operation, on the operation day and 1,3,7 day after operation were measured by radioimmunoassay. Meanwhile, cardio output, central venous pressure and pulmonary capillary wedage pressure were measured by SwanGanz catheter. Results: ANP levels decreased significantly on the operation day and on the first day after operation, and they began to increase on the third and seventh day after operation. Conclusion: The reasons of the decreased level of ANP after operation are due to left and right atrial appendectomy, operation and ischemiareperfusion injuries. These findings suggest that diuretic dosage should be increased during early period after maze operation.