体外循环期间尼莫地平对脑糖代谢的影响

Effects of nimodipine on cerebral glucose metabolism during cardiopulmonary bypass

目的 研究体外循环 ( CPB)中尼莫地平对脑糖代谢的影响。方法 选择 3 1例心脏直视手术病人 ,随机分为对照组 11例 ,观察组 2 0例。尼莫地平 4 0μg· kg- 1 于 CPB始缓慢注入体外循环机中 ,测定不同时期两组病人的动脉、颈内静脉上球部的血糖、丙酮酸、乳酸和乳酸脱氢酶 ( L DH) ,计算出脑糖摄取 GL U( a- v)、乳酸净剩余 ( L v- a)值。结果 CPB过程中两组动脉、颈内静脉上球部的血糖、丙酮酸、乳酸和 L DH均进行性升高 ,两组 GL U( a- v)均低于 CPB前 ,但观察组明显高于对照组 ,两组L v- a无显著差异。结论 CPB中尼莫地平明显提高脑糖利用 。

Objective To study the effect of nimodipine on cerebral glucose metabolism during CPB.Methods Thirty one patients undergoing open heart surgery,were randomly divided into two groups,11 cases served as control,20 cases received nimodipine 40μg·kg -1 at the beginning of CPB as treatment group.Arterial jugular bulb blood glucose,lactate,pyruvate,utilization of glucose(Glu(a v)) and extraction of lactate were measured or calculated at various times.Results The levels of arterial jugular blood glucose,lactate,LDH and pyruvate in two groups increased significantly during CPB.(P<0.05).Glu(a v) decreased significantly in two groups,but higher in treatment group than in control group(P<0.05).L(v a) was not different between two groups during CPB (P>0.05) Conclusion There is an inhibition of cerebral glucometabolism during CPB and nimodipine can improve cerebral glucose utilization significiantly,but do not affect the levels of blood glucose and lactate.