心脏围手术期血清一氧化氮及超氧化物歧化酶活性的变化

Changes of Nitric Oxide Level and Superoxide Dismutase Activity in Serum During Perisurgery of Heart

目的 探讨血清一氧化氮 (nitric oxide,NO)水平、超氧化物歧化酶 (superoxide dismutase,SOD)活性在围手术期心肌再灌注损伤中的变化及临床意义。方法 心脏手术组 2 5例 ,分别在术前 1d,主动脉开放后 10 min,术后 1d和 7d采血 ,化学比色法测定血清 SOD,酶标法测定血清 NO。结果 心脏手术组术前 NO为 47μmol/ L± 10μmol/ L ,再灌注 10 min为 80μmol/ L± 10μmol/ L (P<0 .0 1) ,术后 1d,6 7μmol/ L± 12μmol/ L (P>0 .0 5 ) ,术后 7d,49μmol/ L±14μmol/ L (P>0 .0 5 ) ,术前 SOD为 144 Nu/ m± 2 5 Nu/ ml,再灌注 10 min为 114Nu/ m L± 2 4Nu/ m L (P<0 .0 1) ,术后 1d,141Nu/ m L± 2 4Nu/ m L (P>0 .0 5 ) ,术后 7d,144 Nu/ m L± 2 4Nu/ m L (P>0 .0 5 )。血清 NO与 SOD水平呈负相关 (r=-0 .495 ,P<0 .0 5 )。结论 血清 NO水平增高 ,氧自由基大量产生 。

Objective To study the changes of serum NO level and SOD activity during perisurgical myocardial reperfusion injury and their clinical significance.Methods SOD activity and No level in CPB group(n=25) were examined quantitatively with chemical colorimetry and enzyme labeled method respectively, and blood samples were collected 1 day before operation(A),10 minutes after opening of aorta CPB(B),1st(C) and 7th(D) day after operation respectively.Results As for NO,there was remarkable significance between A and B (P<0.01),while no significance was found either between A and C or between A and D.As for SOD,the results were the same.There was a negative correlation between NO level and SOD activity(r=-0.495,P<0.05).Conclusions Increased serum NO level,production of a deal of oxide free radicals and decreased SOD activity were the main reasons for myocardial reperfusion injury.