常温体外循环期间血浆ET、ANP及血流动力学的变化

The changes of plasma ET, ANP concentrations and hemodynamics during normothermic cardiopulmonary bypass

采用Swan-Ganz导管技术和放射免疫检测方法对比研究了常温和低温体外循环(CPB)对犬血流动力学及血浆内皮素(ET)和心钠素(ANP)的影响。结果显示:低温CPB期间外周循环总阻力(TPR)明显高于常温CPB间,并伴有血浆ET水平显著增高;CPB期间血浆ANP几无明显变化。血浆ET水平与TPR是正相关;但ANP与TPR无相关性。结果提示,低温CPB期间血浆ET增加是TPR增高的原因之一;常温CPB期间血浆ET平稳有助于维持CPB期问和CPB后心血管功能的稳定。CPB期间心脏以外器官分泌的ANP对CPB期间的血浆ANP水平及血流动力学影响轻微。

The effects of normothermic or hypothermic cardiopulmonary bypass(CPB)on hemodynamics, plasma levels of endothelin(ET)and atrial natriuetic peptide(ANP)were comparatively studied in dogs with Swan-Ganz catheter technique and radioimmunoassay. The results showed the total peripheral resistance(TPR)during hypothermic CPB was significantly higher than that of the normothermic. Plasm ET levels increased significantly during hypothermic CPB but remained stable during normothermic CPB. Plasma ANP levels almost unchanged during either CPB. Plasma ET level was positively correlated to TPR but ANT level was not. The results suggest that the increased ET levels may be one of the causes of higher TPR during hypothermic CPB;the stable ET levels contributes to the maintenance of cardiovascular function during and after normothermic CPB and the ANP amount secreted beyond the heart has little effect on the plasma level and hemodynamics during CPB.