CAJ | 학술논문

目的：观察体外循环心脏瓣膜手术患者血浆硫化氢（H2S）浓度的改变，并探讨（H2S）与肺损伤的关系。方法选择30例接受心脏瓣膜置换术的患者，分别于CPB开始前、结束时、手术结束后1h、6h、12h抽取动脉血，测定血浆H2S浓度，并测定动脉血气分析，计算呼吸指数（RI）及氧合指数（OI）。结果在手术结束后1h及结束后6h血浆H2S浓度与CPB开始前（基础值）及CPB结束时相比差异有统计学意义（P<0.01），其中在手术结束后1h血浆H2S浓度达到最高峰值，之后呈下降趋势，12h后接近基础值；血浆H2S浓度与RI数呈高度正相关（r=0.49，P=0.006），与OI呈高度负相关（r=0.54， P=0.002）。结论体外循环可引起H2S浓度增高，且与肺损伤相关。
목적：관찰체외순배심장판막수술환자혈장류화경（H2S）농도적개변，병탐토（H2S）여폐손상적관계。방법선택30례접수심장판막치환술적환자，분별우CPB개시전、결속시、수술결속후1h、6h、12h추취동맥혈，측정혈장H2S농도，병측정동맥혈기분석，계산호흡지수（RI）급양합지수（OI）。결과재수술결속후1h급결속후6h혈장H2S농도여CPB개시전（기출치）급CPB결속시상비차이유통계학의의（P<0.01），기중재수술결속후1h혈장H2S농도체도최고봉치，지후정하강추세，12h후접근기출치；혈장H2S농도여RI수정고도정상관（r=0.49，P=0.006），여OI정고도부상관（r=0.54， P=0.002）。결론체외순배가인기H2S농도증고，차여폐손상상관。
Objective To observe the plasma hydrogen sulfide(H2S)concentration change in cardiac valve replacement patients with cardiopulmonary bypass and to explore its significance. Methods 30 patients undergoing cardiac valve replacement were selected , arterial blood was drawn respectively before the start and at the end of CPB,and at 1h,6h,12h after surgery. The concentration of plasma H2S and arterial blood gas analysis were measured, respiratory index(RI)and oxygenation index(OI) were calculated. Results (1)At 1h and 6h after the surgery,the plasma H2S concentration were significantly differences(P<0.01) compared with the plasma H2S concentration before the start(base value)and at the end of CPB,and the plasma H2S concentration at 1 h after surgery reached the peak,then kept decreasing until reaching the base value after 12h;(2)The plasma concentration of H2S was positively correlated with RI(r=0.49,P=0.49),and was negatively correlated with OI(r=0.54,P=0.54). Conclusion CPB can cause H2S concentration significantly increased,and has a clear relationship with lung injury.