体外循环心内直视手术对病人颅内血浆S-100蛋白水平影响因素分析

Investigation on risk factors of cerebral venous blood S-IO0 protein levels after CPB for open heart surgery

目的分析体外循环心内直视手术后病人颅内血浆S-100蛋白水平的影响因素,以提高心内直视手术后病人神经系统并发症的诊治水平。方法择期心内直视手术病人18例,在CPB结束后30 min采集颈内静脉球部血液检测S100蛋白水平。并用多因素线性回归分析模型评价各影响因素的作用大小。结果体外循环后神经系统并发症的相关危险因素包括病人年龄、体外循环时间和停机后颅内血浆乳酸浓度。结论本研究提示在体外循环心内直视手术的临床监测指标中患者的年龄、体外循环时间和颅内血浆乳酸水平与术后神经系统并发症的发生高度相关。

Objective To analyze the risk factors of cerebral venous blood S-100 protein levels after CPB for open heart surgery and to improve the management for the patients underwent CNS complications. Methods Eighteen consecutive patients, who were classified ASA physical status 2 or 3, scheduled for elective cardiac surgery were included in the study. Patients with history of hypertension, cerebral diseases and endocrine system diseases were excluded. Catheters were placed in the left jugular bulb for sampling of jugular bulb venous blood. Blood samples were collected simultaneously for determination of S-100 protein after CPB 30 minutes. And the multivariate liner regress analysis model was used to evaluate the influence of the variables. Results Multivariate liner regress analysis showed that cerebral venous blood S-100 protein levels after CPB for open heart surgery was related with the CPB time, the age of patients and the level of LAC. Conclusions This study shows the CPB time,the age of patients and the level of LAC are risk factors of S-100 protein.