体外循环前后心肌和血清地高辛浓度的变化及影响其变化的多因素分析.docVIP

???? 体外循环前后心肌和血清地高辛浓度的变化?及影响其变化的多因素分析 ???? ????摘要　目的：探讨体外循环对成人心肌和血清地高辛浓度的影响及影响其改变的多因素分析。方法：成年病人术前口服按体重计算的维持剂量的地高辛一周以上，用Park的方法提取心肌内的地高辛，然后再用放免法测定转机前后心肌地高辛含量和血清地高辛浓度；对可能影响其浓度的各因素进行多元回归分析。结果：血清地高辛浓度停机时最低(0.603±0.316 μg/L)，转机前最高(0.995±0.409 μg/L)，停机后4h有回升现象(0.837±0.383 μg/L)；心肌地高辛的含量停机时(34.839±8.935 μg/kg)较转机前(25.391±6.538 μg/kg)高；血清地高辛浓度和心肌内地高辛含量相关性差(P＞0.05)。多因素分析提示：影响心肌和血清地高辛各浓度的因素各不相同。结论：体外循环使血清地高辛浓度下降，但有回升现象，而心肌中浓度则不下降；地高辛的血清浓度与心肌含量相关性差；影响心肌和血清地高辛浓度改变的因素各不相同。　　主题词　体外循环；地高辛；心肌；方差分析 Digoxin contents of myocardium and serum and an analysis of multipleaffecting factors during extracorporeal circulation (ECC) YIN Sheng-Li, SUN Pei-Wu, ZHONG Fo-Tian, ZHANG XiDepartment of Cardiosurgery, The First Affiliated Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou (510080) 　　Abstract　AIM: To study digoxin levels of myocardium and serum and possible factors affecting them during ECC in adults.METHODS:All adult patients were given maintaining dosage of digoxin over one week.Using Park method to abstract digoxin from myocardial samples, digoxin contents of myocardium and serum were detected with radio-immunity.All data were presented as 887-1 (95 字节) src=/med/cano/201003/20100310162319871 14 19±s, and analyzed by ANOV and relationship analysis on couple data.Progress regression analysis was used to find out clinical related factors that affected myocardial and serum digoxin contents during ECC in adults.RESULTS:(a) Post-ECC serum levels ［(0.603±0.316) μg/L］ were the lowest,while the highest were pre-ECC ［(0.995±0.409) μg/L］.They would return higher 4 hours after ECC［(0.837±0.383)μg/L］.(b) The myocardial digoxin contents of post-ECC［(34.839±8.935) μg/kg］ were higher than that of pre-ECC ［(25.391±6.538) μg/kg］.(c) There was poor relationships between serum levels and myocardial contents (P＞0.05).(d) Analysis of multiple factors showed that different factors had different effect on digoxin contents of myocardium and serum during different periods of ECC.CONCLUSION: