PGE_1对体外循环术后肺高压及右心功能的影响

Effect of Prostaglandin E, on Pulmonary Hypertension and Right Heart Functions after CPB

目的研究体外循环（ＣＰＢ）前后肺动脉压（ＰＡＰ）及有心功能的变化，并探讨前列腺素Ｅ１（ＰＧＥ１）对ＣＰＢ后肺高压及右心功能的影响。方法１２条狗随机分为实验组（ＰＧＥ１组）和对照组，经体外循环６０ｍｉｎ后观察ＰＡＰ及右心功能的变化以及ＰＧＥ１干预作用。结果ＣＰＢ后，ＰＡＰ较ＣＰＢ前有明显升高，反映右心功能的指标如心输出量（ＣＯ）、射血分数（ＥＦ）、心指数（ＣＩ）等则有明显降低。与对照组相比，ＰＧＥ１组ＣＰＢ后ＰＡＰ明显降低，而右心功能有明显升高，体循环压力在ＣＰＢ前后两组间无明显差异。结论ＣＰＢ可引起肺高压及右心功能的降低，ＰＧＥ１可以选择性的作用于肺血管，降低肺动脉压力，促进术后右心功能的恢复。

Objective To study the pulmonary artery pressure(PAP) and right heart functions after cardiopulmonary bypass(CPB) and the protective effect of prostaglandin E1. Methods Twelve mongrel dogs were randomly divided into two groups: control group (C) and PGE, group (P). After 60min of CPB, the changes of PAP and right heart function were observed. Results The PAP level was much biger than the pre-CPB (P<0.01). Right heart functions, including cardiac output (CO), cardiac index (CI) and eject fraction (EF) were much reduced after CPB(P<0.01). With PGE1 infusion after CPB, the PAP was markedly reduced (P<0.01) whereas the CO, EF and CI were significantly increased (P<0.01), compared with the control group. The systemic pressure was not changed (P>0.05) between the two groups. Conclusion CPB can cause pulmonary hypertension and right heart dysfunction. PGE1s can effectively reduce pulmonary hypertension and increase right heart functions.