婴幼儿体外循环对红细胞内钙离子浓度的影响

Changes of intra-erythrocyte calcium concentration during cardiopulmonary bypass in pediatric patients

目的 通过比较先天性心脏病患儿体外循环（cardiepulmonary bypass,CPB）过程中红细胞内外钙离子浓度的变化,探讨CPB对红细胞形态和功能的影响.方法 分别于CPB前、中、后抽取26例先天性心脏病患儿的中心静脉血检测血浆游离钙离子浓度,同时采用Fluo-3-AM测定红细胞内的钙离子浓度.结果 CPB中血浆钙离子浓度由CPB前的（1.24±0.06）mmol/L降低至（0.99±0.05）mmol/L,CPB后钙离子浓度又恢复至（1.28±0.08）mmol/L;CPB过程中红细胞内钙离子浓度则维持了相对稳定[CPB前（138±72）nmol/L;CPB中（145±70）nmol/L;CPB后（115±83）nmol/L].结论 CPB期间红细胞内钙离子浓度无显著变化.

Objective To study the changes of intra-erythrocyte calcium concentration during cardiopulrnonary bypass（ CPB ）.Methods 26 pediatric patients undergoing surgical repair of ventricular or atrial sepal defect under CPB were enrolled in this prospective study. Heparinized venous blood samples were taken from the central vein before CPB, at the beginning of CPB and after CPB, respectively. The concentrations of intra-erythrocyte [ Ca2＋] were measured by fluorescent probes （Fluo-3-AM）, while plasma [Ca2＋] were determined by blood gas analyzer. Results Before CPB and after CPB, the concentrations of plasma[ Ca2＋]were （ 1.24±0.06） mmol/L and （1.28±0.08） mmol/L, respectively. It remarkably decreased at the beginning of CPB （0.99±0.05） mmol/L. There were no significant differences in the levels of intra-erythrocyte[ Ca2＋ ] concentration among the three time points[ （138±72） nmol/L vs （145±70） nmol/L vs （115±83） nmol/L]. Conclusion CPB doesn＇t change the intra-erythrocyte calcium concentrations.