概括
通过心肺旁路进行心脏手术会改变皮质醇反应,在旁路期间显示较低的水平和手术后的升高水平,与对照组相比. 上腺对ACTH的反应在绕道过程中保持不变.
科学领域:
- 内分泌学 在内分泌学.
- 心血管外科心血管外科
- 身体生理学 身体生理学
背景情况:
- 通过心肺旁路进行心脏手术是显著的生理压力因素.
- 了解内分泌反应,特别是皮质醇,对于患者管理至关重要.
研究的目的:
- 为了研究血皮质醇和血自由皮质醇响应模式,在接受心肺旁路心脏手术的患者中.
- 为了将这些模式与接受闭合 mitra valvotomy 的控制患者的模式进行比较.
主要方法:
- 研究了20名接受心肺旁路心脏手术的患者和16名接受闭合心交管切除术的对照患者.
- 在不同时间点测量了血总皮质醇和血自由皮质醇水平.
- 在手术期间使用合成ACTH刺激评估上腺皮质反应.
主要成果:
- 绕道术患者在体外循环 (ECC) 期间血皮质醇总量下降,与表现出典型应激反应的对照群不同.
- 皮质醇水平升高在旁管患者的手术后24-48小时内持续存在.
- 上腺对ACTH的反应在绕道过程中是完整的,但在操作过程中没有控制.
- 在ECC开始时,自由皮质醇的百分比上升,但在绕道术患者的ECC期间,血自由皮质醇总量较低.
- 经手术后的血自由皮质醇在绕道术患者中显著增加.
结论:
- 心肺旁路显著改变了正常的皮质醇应激反应模式.
- 上腺皮层在心肺绕行术期间保持对ACTH的响应能力.
- 在接受心肺旁路心脏手术的患者中,术后皮质醇水平升高.
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