摘要
目的研究高氧分压体外循环对先天性心脏病儿的再氧合损伤。方法选择20例先天性心脏病患者,按照病种随机分成2组,第一组:非紫绀型先天性心脏病(n=10);第二组:紫绀型先天性心脏病(n=10)。体外循环均采用100%氧气预充和转流,在体外循环开始前、1min、5min和10min,分别测定颈内静脉血心肌肌钙蛋白(cTnI)、S100β蛋白(S100)和丙二醛(MDA)含量,同时观察临床指标。结果体外循环前,两组cTnI、S100β和MDA含量均在正常水平,无显著差别。体外循环开始三者均明显上升,血清cTnI含量在体外循环开始1min,5min时,紫绀型组升高水平均高于非紫绀型组,差异具有极显著性(P<0.01);血清S100β含量在体外循环开始1min、5min和10min时,紫绀型组均高于非紫绀型组,5min和10min差异具有显著性(P<0.05);血清MDA含量在体外循环开始1min、5min和10min时,紫绀型组均高于非紫绀型组,1min、5min和10min差异均具有显著性(P<0.05)。临床指标无明显差异。结论高氧分压体外循环再氧合可导致心肌和脑组织氧自由基介导的再氧合损伤;而且紫绀型先天性心脏病患者再氧合损伤比非紫绀型先天性心脏病患者更严重。
OBJECTIVE To investigate the reoxygenation injury of hyperoxic cardiopulmonary bypass （CPB） to the children with congenital heart defects. METHODS 20 patients with congenital heart defect were randomly allocated in two groups according to the diseases,ie, the acyanotic group（ n = 10） and cyanotic group（ n = 10） . All patients had CPB primed and iniated at a fraction of inspired oxygenation（ FiO2 ） of 1.0. In jugular venous blood samples cTnI, S100β and malondialdehyde（MDA） were measured at preCPB, l minute ,5 minutes and 10 minutes after CPB. Clinical variations were observed. RESULTS There was no difference in cTnI,S100β and MDA between th two groups before CPB , cTnI, S100β and MDA level rose progressively after initation of CPB in the two groups. There was significant difference of cTnI at 1 minute and 5 minutes between the two groups （ P 〈 0.01 ） S100β and MDA level rose markedly in the cyanotic group compared with the acyanotic group at 5 minutes and 10 minutes after initation of CPB（ P 〈0.05 ）. There was no diference between the two groups in clinical observation. CONCLUSION Hyperoxic CPB leads to direct myocardial and cerebral injury induced by oxygen free radical. Reoxygenation injury was more severe in the cyanotic group than the acyanotic group.
出处
《中国体外循环杂志》
2005年第3期131-133,共3页
Chinese Journal of Extracorporeal Circulation
关键词
先天性心脏病
体外循环
再氧合损伤
Congenital Heart Defect
Cardiopulmonary Bypass
Reoxygenation Injury
