CAJ | 학술논문

目的:探讨体外循环(Cardiopulmonary bypass,CPB)对小儿先天性心脏病围手术期神经肽Y(Neuropeptide Y,NPY),P物质(Substance P,SP),血管紧张素Ⅱ(Angiotensin II,Ang II)和降钙素基因相关肽(Cateitonin gene related peptide,CGRP)血浆浓度的影响和临床意义.方法:选择20例先天性心脏病患儿,分别在转机前,转机中(CPB开始7 min),转机后(体外循环停止后即刻)以及手术后12h采集血标本,用放射免疫法测定上述四种神经肽血浆浓度.结果:与转机前相比,转机中以及转机后,NPY、SP、AngⅡ和CGRP浓度均有显著上升(P<0.05),手术后12 h,NPY、SP、AngII和GCRP的浓度回落,与转机前无统计学差异(P>0.05).体外循环时间与转机后神经肽浓度成正相关(P<0.05).结论:体外循环是一种非生理性灌注,可以导致神经肽含量的明显变化,因而可对机体产生不同的影响.缩短体外循环的时间,保持神经肽的相对平衡,可能对机体的康复有重要意义.
목적:탐토체외순배(Cardiopulmonary bypass,CPB)대소인선천성심장병위수술기신경태Y(Neuropeptide Y,NPY),P물질(Substance P,SP),혈관긴장소Ⅱ(Angiotensin II,Ang II)화강개소기인상관태(Cateitonin gene related peptide,CGRP)혈장농도적영향화림상의의.방법:선택20례선천성심장병환인,분별재전궤전,전궤중(CPB개시7 min),전궤후(체외순배정지후즉각)이급수술후12h채집혈표본,용방사면역법측정상술사충신경태혈장농도.결과:여전궤전상비,전궤중이급전궤후,NPY、SP、AngⅡ화CGRP농도균유현저상승(P<0.05),수술후12 h,NPY、SP、AngII화GCRP적농도회락,여전궤전무통계학차이(P>0.05).체외순배시간여전궤후신경태농도성정상관(P<0.05).결론:체외순배시일충비생이성관주,가이도치신경태함량적명현변화,인이가대궤체산생불동적영향.축단체외순배적시간,보지신경태적상대평형,가능대궤체적강복유중요의의.
Objective: To explore the effect of cardiopulmonary bypass on the concentration of neuropeptide Y (NPY),Substance P(SP),angiotensin II (Ang II )and calcitonin gene relative peptide (CGRP) during cardiopulmonary bypass in child heart surgery,and to determine their clinical significance.Methods:20 children with congenital heart disease were chosen in hospital.Blood samples were taken from central vein to determine the concentration of NPY,SP,CGRP,and Ang II in plasma by radioimmunoassay before CPB,during CPB at 7min,at the termination of CPB,and 12 hours after-opertation.Results:The concentration of NPY,SP,Ang II and CGRP increased significantly during CPB and at the termination of CPB(p<0.05),and restored to baseline at 12h after operation with no significant difference form pre-cardioplumonary bypass(P>0.05).The duration of CPB had positive correlation with the concentration of peptides(P<0.05).Conclusions: Cardiopulmonary bypass is a non-physiological perfusion,The change of peptides is a compensational reaction to cardiopulmonary bypass.Reducing the time of cardiopulmonary bypass and keeping relative balance of peptides may have important significance for recovering from illness.