体外循环心脏瓣膜置换术患者血浆H2S浓度变化及与肺损伤关系的探讨

目的：观察体外循环心脏瓣膜手术患者血浆硫化氢（H2S）浓度的改变，并探讨（H2S）与肺损伤的关系。方法选择30例接受心脏瓣膜置换术的患者，分别于CPB开始前、结束时、手术结束后1h、6h、12h抽取动脉血，测定血浆H2S浓度，并测定动脉血气分析，计算呼吸指数（RI）及氧合指数（OI）。结果在手术结束后1h及结束后6h血浆H2S浓度与CPB开始前（基础值）及CPB结束时相比差异有统计学意义（P〈0.01），其中在手术结束后1h血浆H2S浓度达到最高峰值，之后呈下降趋势，12h后接近基础值；血浆H2S浓度与RI数呈高度正相关（r=0.49，P=0.006），与OI呈高度负相关（r=0.54， P=0.002）。结论体外循环可引起H2S浓度增高，且与肺损伤相关。

Objective To observe the plasma hydrogen sulfide（H2S）concentration change in cardiac valve replacement patients with cardiopulmonary bypass and to explore its significance. Methods 30 patients undergoing cardiac valve replacement were selected , arterial blood was drawn respectively before the start and at the end of CPB,and at 1h,6h,12h after surgery. The concentration of plasma H2S and arterial blood gas analysis were measured, respiratory index（RI）and oxygenation index（OI） were calculated. Results （1）At 1h and 6h after the surgery,the plasma H2S concentration were significantly differences（P〈0.01） compared with the plasma H2S concentration before the start（base value）and at the end of CPB,and the plasma H2S concentration at 1 h after surgery reached the peak,then kept decreasing until reaching the base value after 12h;（2）The plasma concentration of H2S was positively correlated with RI（r=0.49,P=0.49）,and was negatively correlated with OI（r=0.54,P=0.54）. Conclusion CPB can cause H2S concentration significantly increased,and has a clear relationship with lung injury.