心肺转流期间尼克酰胺磷酸核糖转移酶的变化及其与糖代谢的相关性分析

The variance of Nicotinamide phosphoribosyltransferase(NAMPT)during CPB and its correlation with glucose metabolism

目的探讨心肺转流（CPB）期间尼克酰胺磷酸核糖转移酶（NAMPT）水平的变化及其与糖代谢的关系。方法择期心瓣膜置换术患者36例，于麻醉后5min（T1）、阻断主动脉后5min（T2）、复温后5min（T3）、开放主动脉后5min（T4）、术毕后5min（T5）从中心静脉抽取血标本，检测血清NAMPT、胰岛素水平和全血血糖水平并计算胰岛素抵抗指数（HOMA-IR），分析NAMPT水平的变化及其与糖代谢的关系。结果与T1时比较，T2～T5时患者血清NAMPT、血清胰岛素、血糖和HOMA-IR均明显升高（P〈0．05），且均在L时达到峰值。血清胰岛素水平与NAMPT具有显著正相关（r=0．873，P〈0．01）。结论心瓣膜置换术CPB期间NAMPT和胰岛素的变化具有正相关性，NAMPT可能参与了糖代谢。

Objective To investigate the variance of serum Nicotinamide phosphoribosyltrans- ferase （NAMPT） level during CPB and its relevance to glucose metabolisrrL Methods Thirty-six pa- tients for elective heart valve replacement surgery were enrolled in this study. The blood samples were collected 5 min after anesthesia （T1）, 5 rain after aortic clamping （T2）, 5 min after rewarming （73）, 5 min after aortic clamp releasing （T4） and 5 min after the end of operation （T5）. Serum levels of NAMPT, insulin and blood glucose were detected, and insulin resistance index was calculated. The correlation between serum NAMPT level and glucose metabolism was then analyzed. Results Compared with T1, serum levels of NAMPT and insulin, blood glucose and insulin resistance index were significantly elevated at T2-T5 （P〈0.05）, moreover, the levels were highest at 73. There was a positive correlation between the variance of serum insulin level and NAMPT level（r=0. 873, P〈0. 01）. Conclusion The serum NAMPT level is positively correlated with serum insulin level during CPB.