1,6-二磷酸果糖对心肺转流心脏手术脑损伤的影响

Effects of fructose-1,6-diphosphate on cerebral injury during cardiopulmonary bypass

目的观察1,6二磷酸果糖(FDP)对心肺转流(CPB)心脏手术病人脑损伤的影响。方法选择24例择期行心脏瓣膜置换术病人,随机分为FDP组(F组)和对照组(C组),每组12例。于麻醉后手术前(T1)、复温至36℃(T2)、停CPB30min(T3)、停CPB6h(T4)抽取颈静脉球血,测定S100β蛋白和神经元特异性烯醇化酶(NSE)的含量。结果两组S100β蛋白与NSE在T2至T4时均比T1时有明显升高(P<0.01),但T3至T4时F组S100β蛋白与NSE明显低于C组(P<0.05或P<0.01)。结论FDP可以减轻CPB心脏手术病人的脑损伤。

Objective To investigate the effects of fructose-1,6-diphosphate on cerebral injury during cardiopulmonary bypass（CPB）. Methods Twenty-four NYHA Ⅱ-Ⅲ patients （13 male,11 female） aged 25-45 years,undergoing selective cardiac valve replacement under hypothermic CPB were randomly divided into two groups with 12 cases each. Blood samples were taken from jugular bulb after induction of anesthesia（T1 ）,at the time of rewarming to 36℃ （T2）,30 min （T3） and 6 h （T4） after discontinuation of CPB, for determination of plasma S100β protein and neuron specific enolase （NSE） concentration. Results Plasma levels of S100β protein and NSE increased from T2 to T4 in both groups, but they were lower at T3 and T4 in group F than those in group C （P〈0. 05 or P〈0. 01）. Conclusion Fructose-1, 6-diphosphate can alleviate cerebral injury during open heart surgery under CPB.