心脏不停跳二尖瓣置换术血浆内皮素变化的研究

Changes of endothelin-1 in patients suffering hypothermic replacement of mitral valve in beating hearts

目的探讨不同温度心脏不停跳二尖瓣置换术对心肌保护效果。方法将60例风湿性心脏病二尖瓣病变的患者随机分为实验组(中度低温心不停跳组)与对照组(浅低温心脏不心停跳组),每组30例,于6个时点采静脉血,检测血浆内皮素(ET)。结果实验组与对照组转机后ET持续升高,与CPB前比较差异有统计学意义(P<0.05)。转机40 min,并行15、30 min及停机后30 min实验组较对照组升高明显,差异有统计学意义(P<0.05)。结论浅心脏不停跳联合瓣膜置换术减少了ET的合成及释放,可能具有较好的心肌保护效果。

Objective To study the myocardial protective effects of different temperatures during mitral valve replacement in beating hearts. Methods Sixty patients underwent united cardio valve replacement were randomly divided into experimental group （median hypothermic in beating heart, n = 30）and control group （with mild hypothermic in beating heart, n = 30）. Plasma endothelin-1 of tow groups were respectively measured and compared at six different time intervals. Results Endothelin-1 in both groups increased continuously after CPB beginning （ P 〈0.05）. Compared with the control group, the endothelin-1 increase were more significant in the experimental group 40min after CPB and maintained 30min after CPB ending（P〈0.05）. Conclusion Hypothermic valve replacement in beating hearts reduces endothelin-1 synthesis and release,signifying better myocardial protective effects.