兔一侧全肺切除术后血浆心钠素变化

THE CHANGE OF PLASMA ATRIAL NATRIURETIC POLYPEPTIDE AFTER UNILATERAL PNEUMONECTOMY IN RABBITS

目的 :探讨心钠素 (ANP)与全肺切除术后呼吸衰竭的关系。方法 :将兔 30只分为 3组。Ⅰ组 :行左全肺切除 12只兔 ;Ⅱ组 :行右全肺切除 12只兔 ;Ⅲ组 :对照 6只兔。 3组术前术后定时测ANP并行血气分析。均不吸氧。结果 :Ⅰ组和Ⅱ组术后 6 0minANP升高 ,与术前比较 ,差异有显著性 (P <0 0 5 ) ,术后 12 0min与术后 30min和 6 0min比较 ,差异有显著性 (P <0 0 1) ,术后 180min与术后 6 0min和 12 0min比较 ,差异有显著性 (P <0 0 1)。Ⅰ组和Ⅱ组术后 30min开始出现呼吸衰竭 ,对照组无变化 ;ANP与PaO2 ,PaCO2 ,pH的相关系数分别为 :γ=- 0 737,P <0 0 1;γ =0 784,P <0 0 1;γ =- 0 82 6 ,P <0 0 1。结论 :兔一侧全肺切除术后血浆ANP显著升高 ,与低氧血及高碳酸血有良好的相关性 ,可作为肺外科手术后呼吸衰竭诊断的无创指标。

Objective:To assess relationship between atrial natriuretic polypeptide(ANP) and respiratory failure after pneumonectomy. Methods:30 rabbits were randomly divided into three groups. Group Ⅰ (12 rabbits) was treated by left pneumonectomy. Group Ⅱ (12 rabbits) by right pneumonectomy. Gruop Ⅲ: A control group consisted of 6 rabbits. Blood samples were obtained for measurement of ANP at 5 minutes before and 30,60,120,180 minutes after unilateral pneumonectomy. At the same time arterial blood gas was analysed. All rabbits were given no oxygen inhalation. Results:Serum level of ANP greatly increased in rabbits of group Ⅰ and Ⅱ with pneumonectomy 60 minutes after operation, compared with that of pre-operation. Differences were significant(P<0 05).Significant differences were also found in the surum level of ANP between the time of 120 minutes after operation and 30 or 60 minutes after operation (P<0 01). It was also found between the time of 180 minutes after operation and 60 or 120 minutes after operation (P<0 01). Rabbits of both group Ⅰ and Ⅱ showed the preseint of respiratory failure since 30 minutes after operation,but control group has no changes. The correlation coefficient between ANP and PaO 2,PaCO 2, pH respectively were γ=-0.737,P<0 01,γ=0.784,P<0 01,γ=-0.826,P<0 01. Conclusion: Serum concentration of ANP significantly increased after unilateral pneumonectomy, compared to that of pre-operation. It was correlated with hypoxemia and hypercapnia. Detection of ANP is simple and convenience but sensitive. It is advisable as non-invasive indicator for respiratory failure after pulmonary operations.