婴幼儿室间隔缺损并肺动脉高压行直视修补术后肾素—血管紧…

The Change of Renin-Angiotensin-Aldosterone System in Infant and Young Child Patients with Ventricle Septal Defect and Pulmonary Hypertension Undergoing Open Heart Surgery

将２６例婴幼儿室间隔缺损患儿依肺动脉压力高低分成四组，测定术前及术后５天内不同时点血浆肾素活性，血管紧张素和醛固酮水平。结果发现，术后所有患儿的血浆ＰＲＡ，ＡＩＩ和Ａｌｄ均明显高于健康组。术后５天内对照组和轻度肺动脉高压组肾素－血管紧张 －醛固酮系统降至低于术前水平；中度肺动脉组术后ＡＩＩ持续升高。

We examined 26 infant and young child patients with ventricle septal defect and pulmonary hypertension who underwent serial blood sample to measure plasma level of Aldosterone(Ald), Angio-tensin Ⅱ (AII) and plasma Ren·Activity(PRA)before and after open heart surgery. Preoperatively, it was found that the plasma Ald, AII and PRA in all the patients were significantly higher than those in the healthy group(P<0.001). Postoperation. the RAS level of mild Pulmonary hypertension(PH)group decreased and maintained at a low level at 5th post-operative day(P<0.001). The PRA of the moderate PH groupwas at lowest level immediately after operation, and then significantly increased till the 5th postoperative day(P<0.01). However the PRA of the severe PH group was at peak level immediately after operation, and the plasma AII kept decreasing after operation, and maintained at a low level at 5th postoperatively day(P<0.001). The different changes of components of RAS suggest that PH is a important factor to affect the response of RAS to cardiopulmonary bypass and open heart surgery.