体外循环围术期血浆降钙素基因相关肽变化的研究

Changes of plasma calcitonin gene related peptide in perioperative period of cardiopulmonary bypass

目的 研究体外循环围术期血浆降钙素基因相关肽 (CGRP)的变化规律。方法 1.建立猪体外循环心肌缺血再灌注模型 12例 ,应用放射免疫法分别于体外循环前后 6个时间点测定冠状静脉血浆CGRP含量 ,并同时记录心率、血压、左室收缩和舒张末压 ;2 .应用放射免疫法分别对 36例先天性心脏病心内直视手术患者在体外循环前后 7个时间点测定其冠状静脉血浆CGRP含量。结果 冠状静脉血浆CGRP含量在体外循环开始后与体外循环前相比差异无显著性。再灌注后 ,CGRP显著升高 ,随再灌注时间的延长逐渐上升 ,持续至术后4～ 2 4h。心脏再灌注早期CGRP的升高早于血流动力学指标的改善。结论 CGRP对体外循环缺血

Objective To observe the changes of Calcitonin gene related peptide (CGRP) in perioperative period of cardiopulmonary bypass (CPB). Methods A pig model of myocardial ischemia reperfusion injury was established during CPB. Plasma concentration of CGRP of coronary vein was measured by radioimmunoassay on six consecutive periods before, during and after CPB. Heart rate, blood pressure, systolic and diastolic left ventricular pressure were detected simultaneously. Plasma CGRP concentration of coronary vein in 36 patients with congential heart diseases undergone open heart surgery was also determined on seven consecutive periods perioperatively. Results Plasma CGRP level during CPB before cardiac arrest was of no statistical difference compared with that before CPB, while it was markedly increased when the heart was reperfused. It continued to elevate and remained at a high level 4 to 24 hours postoperatively. The elevated level of CGRP appeared earlier than the improvement of hemodynamic parameters.Conclusion The elevated CGRP has a protective effect on the reperfusional myocardium associated with CPB.(Shanghai Med J, 2000,23∶451 453.)