冠状动脉旁路术围术期肺动脉血浆内皮素和降钙素基因相关肽的变化及其对肺循环血液动力学的影响

The changes of plasma endothelin and calcitonin gene-related peptide levels in pulmonary arterial blood and their influence on pulmonary circulative hemodynamics during coronary artery bypass graft surgery

目的 研究冠状动脉旁路术围术期肺动脉血浆内皮素 (ET)和降钙素基因相关肽(CGRP)的变化及其对肺循环血液动力学的影响。方法 将 30例拟行冠状动脉旁路手术 (CABG)病人 ,按是否合并高血压病分为高血压病组 (17例 )和非高血压病组 (13例 ) ,在围术期抽取肺动脉血用放免法测定ET和CGRP值 ;同时记录抽血时点病人肺循环血液动力学参数。结果 肺动脉血浆中ET和CGRP水平虽有明显动态变化 ,但CGRP/ET比值变化并无统计学意义 ,与相应抽血时点肺循环血液动力学参数呈明显负相关 (P <0 0 5 )。结论 在行CABG围术期中 ,肺动脉血浆中ET和CGRP的变化可能是机体的一种自我保护机制 ,使CGRP/ET比值稳定在一定范围。

Objective To investigate the changes of plasma endothelin(ET) and calcitonin gene related peptide(CGRP) levels in pulmonary arterial blood and their influence on pulmonary circulative hemodynamics during coronary artery bypass graft surgery(CABG).Methods Thirty patients scheduled for CABG were divided into two groups:hypertensive group(17 patients) and non hypertensive group(13 patients).Pulmonary arterial blood samples were taken through Swan Ganz catheter for the measurements of ET and CGRP with RIA.Pulmonary hemodynamic parameters were collected at the same times as above.Results During CABG,although plasma ET and CGRP Levels were significantly changed in two groups,CGRP/ET ratio showed no obvious changes( P> 0 05) and was significantly negatively correlated with hemodynamic parameters of pulmonary circulation.Conclusion During CABG,plasma ET and CGRP levels may be a self protective mechanism to maintain the balance of CGRP/ET ratio.