浅低温体外循环心脏跳动中手术血浆心钠素变化的实验研究

STUDY OF PLASMA ATRIAL NATRIURETIC PEPTIDE(ANP) ON BEATING HEART SURGERY WITH MILD HEPOTHERMIC CARDIAPULMONARY BYPASS

目的 :探讨血浆心钠素 (ANP)在浅低温体外循环 (CPB)心脏跳动中心内直视手术过程中的变化和意义。方法 :实验用健康山羊 1 6只 ,随机均分为实验组 (浅低温不停跳组 )与对照组 (中度低温停跳组 ) ,分别在转机前 ,CPB6 0、1 2 0、1 30、1 5 0 min,停机后测定混合静脉血清中 ANP含量。结果 :实验组 ANP在 CPB6 0 min升高 ,在 CPB期间各时点相对稳定 (P >0 .0 5 ) ;ANP在对照组 CPB心停跳期间无明显升高 (P >0 .0 5 ) ,在再灌注后 1 0、30 min明显升高并达峰值 ,与再灌注之前各时点以及实验组相同时点比较差异有统计学意义 (P <0 .0 0 1 ) ,CPB结束后与 CPB前仍有明显差异 (P <0 .0 5 )。结论 :浅低温体外循环心脏跳动中心内直视手术能维持血浆 ANP浓度的稳定 。

Objective:To investigate plasma Atrial Natriuretic Peptide (ANP) changes and the effect of myocardial protection on beating heart surgery with mild hypothermic cardiopulmonary bypass(CPB).Methods:Sixteen goats were randomly divided into experimental and control group; experimental group(n=8), on beating heart surgery with mild hypothermic CPB; control group(n=8), on arrested heart with moderate hypothermic CPB. Plasma ANP of two groups were respectively measured at six different time intervals.Result: ① In experimental group ,ANP increased obviously after CPB 60 minutes(P<0 05), and was comparatively stable duing CPB(P>0 05); ② In control gtoup, ANP was not significantly different at 60 and 120 minutes duing CPB, but markedly increased after aortic cross clamped. The peak plasma of ANP appeared within 10 to 30 minutes after reperfusion(P<0 001), significantly higher than that in other times before reperfusion and same times in experimental group.Conclusion:The stable ANP should be useful in myocardial protection and maintenance of a better physiologic state on beating heart surgery with mild hepothermic cardiopulmonary bypass.