| 摘要: |
| ［摘要］ 目的 研究脑利钠肽和呼吸指数在心脏直视手术围术期的变化及临床意义。方法 对首次择期行心瓣膜置换术患者45例分别于术前30 min、转机30 min、停机时、停机1 h、术后1 d、术后7 d各时点同步监测脑利钠肽、心肌钙蛋白T、呼吸指数的变化，并进行各指标的相关性研究。结果 脑利钠肽水平在体外循环后及手术后均明显升高，至术后1 d达到高峰值, 术后7d水平脑利钠肽下降，但仍明显高于术前水平（P<0.01）；呼吸指数在体外循环后及手术后均明显升高，至体外循环10 min时达到高峰值（P<0.05或P<0.01），术后7 d回落至术前水平（P>0.05）。脑利钠肽变化与心肌钙蛋白T呈正相关（r=0.48，P<0.05）；呼吸指数变化与脑利钠肽、心肌钙蛋白T均未显示相关意义（r=0.23, r=0.17, P>0.05）。结论 同步监测脑利钠肽和呼吸指数的变化为围术期如何保护心肺功能提供依据。 |
| 关键词: 心脏直视手术 脑利钠肽 呼吸指数 |
| DOI：10.3969/j.issn.1674-3806.2009.09.04 |
| 分类号:R 654.1；R 563.9 |
| 基金项目:阳江市科技局科研立项课题（卫200601） |
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| The change of brain natriuretic peptide and respiratory index in perioperative period of open heart surgery and it′s clinical significance |
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LIN Shan-wen, SU Yue-nan, ZHANG Sheng-sun, et al.
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Department of Thoracic Surgery, Yangjiang City People′s Hospital, Guangdong 529500, China
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| Abstract: |
| ［Abstract］ Objective To research on the change of brain natriuretic peptide and respiratory index in perioperative period of open heart surgery and its clinical significance.Methods In 45 patients underwent the first time cardiac valve replacement, at 30 min before operation, CPB 30 min, downtime, the downtime 1 h, 1 d and 7 d after operation，the synchronous monitoring of the brain natriuretic peptide, cardiac troponin T, respiratory index were performed, and the relevance of the research indicators were analysed.Results The level of brain natriuretic peptide after cardiopulmonary bypass surgery were significantly increased to a peak value at 1 d after operation, at 7 d after operation brain natriuretic peptide levels decreased, but still significantly higher than preoperative levels (P<0.01); respiratory index after cardiopulmonary bypass surgery were significantly increased and reached the peak value at 10 mins of cardiopulmonary bypass (P <0.05 or P<0.01), and dropped to preoperative levels at 7 d after operation (P>0.05). There was a positive correlation between brain natriuretic peptide and cardiac troponin T (r= 0.48, P<0.05); respiratory index and brain natriuretic peptide, cardiac troponin T did not show the relevance (r=0.23, r=0.17, P> 0.05).Conclusion Synchronous monitoring of brain natriuretic peptide and respiratory index can to provide a basis for the protection of perioperative cardiopulmonary function. |
| Key words: Open heart surgery Brain natriuretie peptide Respiratory index |
