吸入NO对婴幼儿体外循环中肺表面活性物质的影响

Effects of inhaled nitric oxide on pulmonary surfactant during cardiopulmonary bypass in infants

目的:探讨吸入一氧化氮(NO)对婴幼儿体外循环(cardiopulmonary bypass,CPB)中肺表面活性物质的影响。方法:将30例患室间隔缺损的婴幼儿随机分为对照组和NO组,NO组在CPB期间吸入40μl/L NO直至关胸。CPB前、主动脉开放后1,5,10 min以少量生理盐水灌洗气道,分别测定气道吸出物(BAL)中总磷脂(TPL)、饱和卵磷脂(SatPC)、总蛋白(TP)值,并计算SatPC/TPL和SatPC/TP。结果:CPB后两组SatPC/TPL、SatPC/TP较CPB前明显降低(P<0.01)。NO组SatPC/TPL和SatPC/TP下降的幅度明显小于对照组(P<0.01)。结论:婴幼儿CPB术中存在明显的肺损害,表现为一些亚临床性肺功能损伤。吸入40μl/L的NO对CPB期间肺功能有明显的保护作用。

AIM： To study the effects of inhaled Nitric Oxide （NO） on pulmonary function and pulmonary surfactant during cardiopulmonary bypass in infants. METHODS： Thirty infants with congenital heart disease with the high degree of PH were randomly divided into two groups： control group （n=15） and NO group （n=15）. From throughout the cardiopulmonary bypass（CPB）, 40 μl/L NO was inhaled in NO group. Before CPB and at 1, 5 and 10 min after aortic declamping, air tube was lavaged by small amounts of normal saline, the levels of TPL, SatPC and TP were determined and the values of SatPC/TPL and SatPC/TP were calculated. RESULTS： The levels of SatPC/TPL and SatPC/TP post-operation were lower than those before CPB （P〈0.01） and the decreased formants of SatPC/TPL and SatPC/TP in control group were higher than those in NO group. CONCLUSION： Lung ischemia-reperfusion injury is obvious during CPB in infants and manifests as sub-clinical pulmonary function injury. Inhale 40 μl/L NO has marked protective effect on the lung function during CPB.