中国临床医学2012，Vol.19Issue(1)：14-16,3.
体外循环术围术期血中游离脂肪酸含量与肺损伤的相关性
Elevated Free Fatty Acid Level Contributes to Lung Injury after Cardiopulmonary Bypass
摘要
Abstract
Objective:To investigate the relationship between free fatty acid (FFA) and lung injury during the pcriopcrativc period of cardiopuimonary bypass(CPB). Methods: Sixty patients underwent cardiac surgery on CPB were included, and their clinical information was recorded in detail. The blood samples of the patients were collected at baseline, 10 min after hepariniza-tion, after neutralization by protaminc sulfatc and 2 h after the operation. The levels of FFA, triglyccridc (TG) and total cholesterol (TO were detected in the blood samples. Atcrial blood gas and data of mechanical ventilation were recorded 2 hours after the operation, intcrlcukin (IL)-6, endothclin (ET)-l, tumor necrosis factor (TNF)-a and intercellular adhesion molcculc-1 (ICAM-1) were detected in the blood samples at 2 h after operation. Hypoxcmia was defined as oxygenation index less than 200, and its relationship with the clinical and laboratory parameters to the lung injury was analyzed. Results: There were 22 cases of hypoxcmia 2 hours after the operation. Age, coronary artery bypass graft, duration of cardiopulmonary bapass and postoperative FFA level were risk factors of hypoxcmia. During CPB, the FFA level increased rapidly to 2-5 folds after hepariniza-tion, then droped, but it was still higher after CPB than that before CPB. The FFA level had significant inverse correlation with oxygenation indcx(P<0. 001), and had significant positive correlation with the levels of ICAM-1 (P<C0. 001), while it had no correlation with the levels of IL-6,TNF-a and ET-1. FFA had significant square correlation with prcopcrativc TG (P<C 0. 01) and with postoperative TG (P<0. 001). Conclusions: Elevated FFA level contributed to lung injury after CPB. The possible mechanism may be that high level of FFA induces pulmonary vascular cndothclium abnormality followed by leukocytes adhesion and increased vascular permeability.关键词
体外循环/游离脂肪酸/肺损伤Key words
Cardiopulmonary bypass/ Free fatty acid/ I-ung injury分类
医药卫生引用本文复制引用
虞敏,周黎瑾,董莉亚,王利民,高远,施盛,袁忠祥..体外循环术围术期血中游离脂肪酸含量与肺损伤的相关性[J].中国临床医学,2012,19(1):14-16,3.基金项目
上海市卫生局科研项目(编号:20114267) （编号:20114267）
