1,6-二磷酸果糖对心肺转流期间氧代谢的影响

Effect of fructose-1,6-diphosphate on oxygen metabolism during cardiopulmonary bypass

目的研究1,6-二磷酸果糖(FDP)对心肺转流(CPB)手术期间氧代谢的影响。方法随机将24例CPB手术病人均分成研究组(A组)和对照组(B组)。A组于转机前静滴FDP200mg/kg,B组于转机前滴入等量生理盐水,观察麻醉后(T1)、CPB前(T2)、升主动脉开放后10min(T3)、停CPB后10min(T4)、停CPB后60min(T5)的氧供(DO2)、氧耗(VO2)、氧摄取率(ERO2)及动脉血乳酸(ABL)的变化。结果两组T3时DO2明显降低(P<0.05),T3时A组ERO2和B组VO2、ERO2及两组T4、T5时VO2、ERO2明显增加(P<0.05或P<0.01),T3、T4和T5时ABL明显增加(P<0.01);B组T3、T4和T5时VO2、ERO2、ABL明显高于A组(P<0.05)。结论FDP对改善CPB手术期间氧供需平衡障碍有明显作用。

Objective To study the effect of fructose - 1,6-diphosphate on oxygen metabolism during cardiopulmonary bypass （CPB）. Methods Twenty-four patients undergoing CPB were randomly divided into two groups with 12 cases each. Fructose-I, 6 -diphosphate （FDP） 200 mg/kg was infused intravenously before CPB in the patients of group A, while normal saline was given instead of FDP in those of group B. The changes of oxygen delivery （DO2）, consumption （VO2）, extraction rate （ERO2） and arterial blood lactate（ABL） were observed after anesthesia（T1 ）, before CPB（T2 ）, at 10 min after aorta declamping （T3）, 10 min after CPB（T4 ）, and 60 min after CPB（T0 ）. Results The DOz at T3 was decreased significantly compared to that at Tz in two groups （P^0.05）. The ERO2 in group A and VO2, ERO2 in group B at T3 ,VO2, ERO2 in two groups at T4 ,T0 were significantly more than those at T2 （P〈 0.05 or P〈 0.01）. The ABL at T3, T4 and T0 was increased significantly compared with that at T2 in two groups （P〈0.01） . The VO2, ERO2 and ABL at T3 ,T4 and T0 in group B were significantly higher than those in group A （P〈0.05） . Conclusion There is a certain protective effect of fructose -1,6 -diphosphate on oxygen supply-demand balance during CPB.