体外循环术对婴儿先心病术后肾功能损伤及黄芪的干预作用.docVIP

婴儿先心病体外循环术后肾损伤及黄芪的干预作用 提运幸，潘征夏，吴 春，王 刚，李洪波，李勇刚，安 永，代江涛（重庆医科大学附属儿童医院心胸外科，重庆 400014） 提要 ： 目的 探讨婴儿先心病体外循环（CPB）术后肾损伤及黄芪的干预效果。方法 选取我院2009年10月－2010年7月间先心病患儿40 例，随机分黄芪组和对照组。ELISA法检测两组患儿血清TNF-α、IL-6、CysC和尿NAG浓度。结果 CPB后CysC无明显升高（P0.05）。对照组NAG在术后均有明显升高（P0.05），而实验组术后升高不明显（P0.05）且明显低于对照组（P0.05）；对照组TNF-α和IL-6在术后显著性升高，实验组TNF-α和IL-6明显低于对照组（P0.05）。结论 CPB可导致先心病婴儿肾小管损伤。术前应用黄芪预处理后可对肾小管功能有保护作用。 关键词 ：肾损伤；体外循环；黄芪；婴儿 中图法分类号： R726 Kidney Injury after Cardiopulmonary Bypass and Therpeutic Effect of Astragalus in Infants with Congenital Heart Disease TI Yun-xing, PAN Zheng-xia, WU Chun, WANG Gang, LI Hong-bo, LI Yong-gang, AN Yong, DAI Jiang-tao. Department of Cardiovascular and Thoracic Surgery,Children’s Hospital Affiliated to Chongqing Medical University,Chongqing 400014,China ABSTRACT ：Objective To explore the renal injury and the therpeutic effect of Astragalus after cardiopulmonary bypass in infants with congenital heart disease. Methods 40 infants undergoing cardiac surgery with cardiopulmonary bypass from Oct.2009 to Jul.2010 were randomly divided into 2 groups. The concentrations of serum TNF-α, IL-6, CysC and urinary NAG were detected with ELISA. Results The concentrations of serum CysC were not significantly higher after CPB(P0.05). The levels of urinary NAG increased significantly in controls(P0.05) after surgery, but no significances were found in Astragalus group after surgery, and urinary NAG concetrations in infants of observing group were significantly lower than those in controls (P0.05). After CPB, serum TNF-α and IL-6 increased significantly in control group (P0.05) but serum TNF-α and IL-6 in the treated group were lower than the controls (P0.05). Conclusion CPB can damage renal tubular in infants with congenital heart disease, application of Astragalus injection before the CPB may protect renal tubular function . KEY WORDS ：kidney injury; cardiopulmonary bypass; Astragalus; infant 第一作者：提运幸（1985-），男，山东人，硕士生，研究方向：心胸外科。 通讯作者: 潘征夏(1966-