先天性心脏病儿童围体外循环期内皮素甲状腺素变化

Changes of plasma levels of endothelin and thyroid hormones in children with congenital heart disease during peri CPB period

目的研究先天性心脏病（以下简称先心）儿童围体外循环期血浆内皮素（ＥＴ）与甲状腺素（ＴＨＴ３、ＦＴ３、Ｔ４、ＦＴ４、γＴ３）的变化与相互关系。方法采用自身对照方法研究１４岁以下先心患儿围体外循环期（ＰＣＰＢ）ＥＴ与ＴＨ的变化。结果ＥＴ在体外循环（ＣＰＢ）中先降后升，术后１２ｈ达最高，２４ｈ仍明显高于术前（Ｐ＜００５）与术中（Ｐ＜００１），Ｔ３、Ｔ４的变化趋势同ＥＴ，但术后２４ｈ仍低于术前（Ｐ＜００５），γＴ３的变化趋势与Ｔ３、ＥＴ相反，Ｔ４、ＦＴ４的变化无显著性。相关分析表明ＥＴ与γＴ３在ＰＣＰＢ呈正相关（ｒ＝０８０，Ｐ＜００５），ＥＴ与Ｔ３、ＦＴ３、Ｔ４、ＦＴ４在此期无相关关系。结论先心儿童ＣＰＢ术后使用Ｔ３、内皮素拮抗剂或转换酶抑制剂在理论上是有根据的。

Objective To examine the changes of plasma levels of endothelin (ET) and thyroid hormones (TH T 3、T 4、FT 3、FT 4、γT 3) in children with congenital heart disease (CHD) during peri CPB(PCPB) period. Method By studying the plasma changes of ET and TH in children undergone CPB operation with self control method. Results ET decreased first and then increased and reached its climax twelve hours after operation. The changing trend of T 3 and T 4 was similar with that of ET, but the changing trend of γΤ 3 reverse to that of ET and T 3. There were no significant changes of T 4 and FT 4. Correlation analysis showed that there was a positive correlation of ET with γΤ 3. Conclusion It is theroretically practicable to administrate T 3 or ET antagonist or ET conversing enzyme inhibitor in children with CHD after CPB operation.