心脏手术麻醉和体外循环期间部分神经调节肽的变化及其意义的探讨

Changes of meuropeptides in anesthesia of cardiac operatien and cardiopul menary by pass

目的探讨心脏手术麻醉和体外循环期间部分神经调节肽的变化及其意义。方法观察了15例CPB心内直视手术病人不同时期的血浆AVP、NT、DynA和ATⅡ的变化，以自身对照作t检验。结果血浆AVP在切皮前、转流中、停机后10分钟与麻醉前比较具有高度显著性差异（P＜0．01），术毕时AVP水平仍未恢复到麻醉前水平（P＜0．05）；NT切皮前与麻醉前比较具有高度显著性差异（P＜0．01），CPB期间无显著性差异，DynA切皮前与麻醉前比较具有显著性差异（P＜0．05），CPB期间具有高度显著性差异（P＜0．01）；ATⅡ切皮前与麻醉前比较具有显著性差异（P＜0．05），CPB期间具有高度显著性差异（P＜0．01）。结论麻醉及手术的应激反应可促使AVP、DynA和ATⅡ的分泌释放，NT在CPB期间变化不大，与升高的AVP抑制其释放有关。在心脏手术麻醉和CPB期间神经肽的这种变化，作为判断反应某些种类麻醉是否适度的指标尚需探讨。

Objectives Lnquiringing into the changes of meuropeptides in anesthesia of cardiopul menary by pass. Methods Charges of plas-ma AVP. NT. DynA and ATⅡ during various CPB periods were enamined in 15 cases of intracardial operation under direct vision T-test was carried out by usins auto - control. Results The rcsults obtained showed that the anesthesia and stress reaction could promote the release of AVP、DynA and AT Ⅱ. There was no obvious changes in the level of NT during various CPB periods, which might be the reason that an incrcasing of AVP would inhibit the release of NT. Conclusions It is suggested that the changes of the four neuropep-tides during anesthesia and CPB periods are of very important in keeping the stability of circulation and ensuring the blood supply for mam organs.