【摘要】 探讨体外循环（ＣＰＢ）溶血引起的肾功能损害及前列腺素Ｅ１（ＰＧＥ１）对肾功能的保护作用。方法将２０例心脏瓣膜置换手术的患者随机分为两组，每组１０例。实验组：ＣＰＢ前静滴ＰＧＥ１３０分钟，１００ｎｇ·ｋｇ－１·ｍｉｎ－１；预充液中加１００ｎｇ／ｍｌ；ＣＰＢ中，３０ｎｇ·ｋｇ－１·ｍｉｎ－１静滴维持。对照组：不给ＰＧＥ１而只给生理盐水。然后分别测ＣＰＢ围术期游离血红蛋白（Ｆ－Ｈｂ），尿β－Ｎ－乙酰氨基葡萄糖苷酶（ＮＡＧ），β２微球蛋白（β２－ＭＧ）。结果随ＣＰＢ时间增加，Ｆ－Ｈｂ增加，β２－ＭＧ、ＮＡＧ／肌酐（Ｃｒ）增加。Ｆ－Ｈｂ对照组最大值在ＣＰＢ终止后２小时，实验组最大值在ＣＰＢ终止时。ＣＰＢ１小时，对照组和实验组的Ｆ－Ｈｂ分别为：４１５±３６ｍｇ／Ｌ和２５９±３７ｍｇ／Ｌ，Ｐ＜０．０５。ＣＰＢ终止后２小时，对照组和实验组的Ｆ－Ｈｂ分别为６０７±９９ｍｇ／Ｌ和２９７±４１ｍｇ／Ｌ，Ｐ＜０．０５。ＣＰＢ后２小时，对照组和实验组的β２－ＭＧ分别为６７５±８３９μｇ／Ｌ和３１６７±３０２μｇ／Ｌ，Ｐ＜０．０１。ＣＰＢ后２小时，对照组和实验组的ＮＡＧ／Ｃｒ比值分别为１８３９±３１１和７７０±８０，Ｐ＜０．０１。结论?更多还原

【Abstract】 Objective To observe the renal function protection of PGE 1 from hemolysis caused by CPB during and after CPB. Method F Hb in blood、NAG & β 2 MG in urine were measured in twenty patients who underwent valvular replacement operation. The patients were divided into two groups at random. The PGE 1 group was administered of PGE 1 with the dose of 100ng/kg·min for 30′ before CPB, 30ng/kg·min during CPB intravenation and 100ng/ml before CPB in CPB mechanical equipment. The control group was administered of N.S.. Results After termination of CPB, F Hb rose continuously, showing that the damaging RBC factors did not stop working at once after CPB. F Hb and β 2 MG were positively correlated and F Hb and NAG/Cr were positively correlated, demonstrating that increased F Hb is an important factor for renal function damage. At 60 minutes after CPB and 120minutes after CPB,F Hb values of PGE 1 group were signficantly lower than those of the control group. β 2 MG and NAG/Cr of the PGE 1 group also showed the same trend. The peak of the control group F Hb was later than that of the PGE 1 group. Conclusions The results demonstrate that PGE 1 can protect renal function by decreasing F Hb level during CPB and shortening the time of hemolysis after CPB.更多还原