成人心脏瓣膜替换术前后血清胰岛素水平的变化

Levels of Serum Insulin During Peri - Cardiopulmonary Bypass Period in Adult Valve Replacement

作者观察了２８例心脏瓣膜替换术围术期血清胰岛素的变化，结果发现：体外循环（ＣＰＢ）过程中（ＣＰＢ３０分钟、ＣＰＢ６０分钟）至手术次日晨，血清胰岛素含量较术前均有显著升高，而全身麻醉诱导及肝素化对胰岛素水平无明显影响。

Serum insulin was measured in 28 adult patients who underwent valve replacement before,during and after cardiopulmonary bypass(CPB).Blood samples for assaying levels of serum insulin were taken at different time intervals.The findings showed a significant increase in serum insulin levels during and after CPB and the day after surgery as compared with levels at the time of admission.The differences between the levels of serum insulin after administration of general anesthetics and that following the injection of heparin,and levels at the time of admission were not significant.The difference between serum insulin levels at the end of CPB and on the day following surgery were not significant.The results indicated that serum insulin levels during and after CPB period rose to significantly higher levels than that before CPB even in hypothermia and during CPB,and remained high at least until the day following open heart surgery. Consequently,the authors are of the opinion that it may not be necessary to infuse insulin in priming solution and/or cardioplegic solution to prevent free radical-mediated myocardial reperfusion injury.