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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

20卷

期数:

2014年04期

页码:

282-285

栏目:

基础医学

出版日期:

2014-07-08

文章信息/Info

Title:

Extracorporeal membrane oxygenation affects the concentrations of ANP, BNP, NT-pro BNP and ET-1 in plasma of dogs

文章编号:

1006-8147（2014）04-0282-04

作者:

刘天悦¹; 2 ; 段大为²;  李 彤²

(1.天津医科大学第三中心临床学院,，天津 300170; 2.天津市第三中心医院心外科, 天津 300170)

Author(s):

LIU Tian-yue¹; 2; DUAN Da-wei²; LI Tong²

(1 . The Third Central Clinical Institute ,Tianjin Medical University ,Tianjin 300170, China; 2.Department of Cardiac Surgery,Tianjin Third Central Hospital , Tianjin 300170, China)

关键词:

体外膜肺氧合; 心钠肽; 脑钠肽; N末端脑钠肽; 内皮素-1; 心肌功能; 犬

Keywords:

extracorporeal membrane oxygenation;  atrial natriuretic peptide;  brain natriuretic peptide;  N terminal pro-brain natriuretic peptide;  endothelin-1;  myocardial function;  dog

分类号:

R614

DOI:

-

文献标志码:

A

摘要:

目的：通过动态监测体外膜肺氧合（ECMO）过程中血浆心钠肽（ANP）、脑钠肽（BNP）、N末端脑钠肽（NT-pro BNP）及内皮素-1（ET-1）浓度的变化，寻找监测ECMO过程中心肌功能变化的有效指标。方法：选择健康雄性杂种犬6只，于股动静脉行V-A ECMO，在ECMO开始前30 min和开始后1、2、3、6、24、36 h取血浆，应用ELISA检测血浆ANP、BNP、NT-pro BNP和ET-1的动态变化。结果：与ECMO开始前比较，转流开始后3 h血浆BNP浓度显著升高，差异有统计学意义（P＜0.05），24 h到达最高值16.12 pg/mL，之后呈下降的趋势，在第36 h时下降至13.53 pg/mL；转流开始后24 h血浆NT-pro BNP浓度显著升高（P＜0.05），并达到最高值541.83 pg/L，36 h时NT-pro BNP浓度又显著下降至460.05 pg/L；转流开始后1 h ANP浓度显著升高（P＜0.05），并达到最高值26.33 pg/mL，之后恢复到转流前水平，24 h时再次升高达到23.75 pg/mL，但与转流开始前相比，差异无统计学意义（P＞0.05），之后逐渐下降；转流开始后1 h与转流前30 min相比，血浆ET-1浓度显著下降至65.07 pg/mL（P＜0.05），之后又恢复到ECMO开始前水平。结论： 血浆BNP、NT-pro BNP、ANP和ET-1浓度可作为监测ECMO对心肌功能影响的有效指标。

Abstract:

Objective: To explore useful indicators to monitor the change of myocardial function during ECMO by examining the dynamic changes of the concentrations of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), N terminal pro-brain natriuretic peptide (NT-pro BNP) and endothelin-1 (ET-1) in the plasma of dogs. Methods: Six healthy mongrel male dogs were selected, treated by V-A ECMO at the femoral artery and femoral vein. The plasma samples were collected at the 30 minutes before the ECMO began and at 1^st hour, 2^nd hour, 3^rd hour, 6^th hour, 24^th hour and 36^th hour after it. ANP, BNP, NT-pro BNP and ET-1 in the plasma were measured by ELISA to determine the dynamic changes of those. Results: Compared with the plasma level before ECMO, the concentration of BNP increased significantly at 4^th, 5^th, 6^th, 24^th hours after ECMO began (P＜0.05), reaching the highest level 16.12 pg/mL at 24^th time point, then decreasing to the level before ECMO began; the concentration of NT-pro BNP increased significantly at 24^th time point after ECMO began(P＜0.05) and reached to the highest level 541.83 pg/L ,then decreased again to 460.05 pg/L; the concentration of ANP increased significantly at 1^st hour after ECMO began(P＜0.05), reaching the highest point of 26.33 pg/mL, while at 24^th hour increased again to 23.75 pg/mL. But no statistical difference was found（P＞0.05）. The concentration of ET-1 decreased significantly at 1^st hour after ECMO began (P＜0.05), dropping to 65.07 pg/mL, then recovered to the level before ECMO began. Conclusion: The concentrations of BNP, NT-pro BNP, ANP and ET-1 in the plasma can be used to monitor the dynamic change of myocardial function during ECMO.

参考文献/References:

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备注/Memo

备注/Memo:

基金项目  天津市科学技术委员会重点项目（11ZCGYSY02000）；天津市卫生行业重点攻关项目（12KG106）

作者简介  刘天悦（1978-），男，主治医师，硕士在读，研究方向：临床麻醉学；通信作者：李彤，E-mail：litong3zx@sina.com。

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更新日期/Last Update: 2014-06-06