Resistance to prostaglandin E<sub>1 </sub>in postoperative early stage of valvular replacement in rheumatic heart disease patients

李志平; 范士志; 蒋耀光; 王如文; 陈建明; 牛会军; 何勇; 郭伟; 沈诚

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Resistance to prostaglandin E₁in postoperative early stage of valvular replacement in rheumatic heart disease patients

更新时间：2026-01-09

- Resistance to prostaglandin E₁in postoperative early stage of valvular replacement in rheumatic heart disease patients
- Journal of Army Medical University Vol. 29, Issue 9, Pages: 792-795(2007)
- 作者机构：
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  CLC： R543.2;R654.1R972.4
- Published：2007
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李志平,范士志,蒋耀光,王如文,陈建明,牛会军,何勇,郭伟,沈诚.风心病合并肺动脉高压体外循环后前列腺素E1抵抗现象的研究[J].陆军军医大学学报(原第三军医大学学报),2007,29(09):792-795.

　LI Zhi-ping,FAN Shi-zhi,JIANG Yao-guang,WANG Ru-wen,CHEN Jian-ming,NIU Hui-jun,HE Yong,GUO Wei,SHEN Cheng.Resistance to prostaglandin E1 in postoperative early stage of valvular replacement in rheumatic heart disease patients[J].J Amry Med Univ (J Third Mil Med Univ),2007,29(09):792-795.
李志平,范士志,蒋耀光,王如文,陈建明,牛会军,何勇,郭伟,沈诚.风心病合并肺动脉高压体外循环后前列腺素E1抵抗现象的研究[J].陆军军医大学学报(原第三军医大学学报),2007,29(09):792-795. DOI：

　LI Zhi-ping,FAN Shi-zhi,JIANG Yao-guang,WANG Ru-wen,CHEN Jian-ming,NIU Hui-jun,HE Yong,GUO Wei,SHEN Cheng.Resistance to prostaglandin E1 in postoperative early stage of valvular replacement in rheumatic heart disease patients[J].J Amry Med Univ (J Third Mil Med Univ),2007,29(09):792-795. DOI：

摘要

目的探讨风心病合并肺动脉高压患者在围术期治疗中前列腺素E

(PGE

)的作用规律，为临床提供理论依据。方法 28例分为2组：实验组(A组)14例，于术中停体外循环(CPB)后开始应用PGE

，20 ng·kg

-1

·min

-1

，之后每10分钟增加20 ng·kg

-1

·min

-1

，直至100 ng·kg

-1

·min

-1

维持10 min，连续观察体肺循环压力变化，间隔10 min测量心脏指数(CI)1次，共测量6次；其中7例(A1)术后24 h重复上述操作1次，其余7例(A2)采用生理盐水作为对照；对照组(B组)14例，术中及手术当日均不使用前列腺素E

，其中7例(B1)术后24 h按A组方法给药1次，其余7例(B2)采用生理盐水作为对照。术后24 h实验组14例(C组=A1+B1)，对照组14例(D组=A2+B2)。结果术中A组和B组平均肺动脉压(MPAP)下降比较相差不显著(P0.05)，心脏指数（CI）、体循环阻力(SVR)、肺循环阻力(PVR)、肺动脉楔压(PAWP)变化均无显著性差异(P0.05)；术后24 h C、D组平均肺动脉压(MPAP)下降相差显著(P0.05)，两组心脏指数（CI）变化相差非常显著(P0.01)。结论风心病合并肺动脉高压患者在瓣膜置换术后，麻醉状况下对前列腺素E

存在抵抗现象，而在清醒状况下前列腺素E

能扩张肺血管，降低肺动脉压，提高心脏指数，改善心功能。

Abstract

Objective To study the rule of surgical treatment for rheumatic heart disease in the postoperative stage of valve replacement. Methods Twenty-eight cases

suffered from rheumatic heart disease

were randomly divided into two groups

group A and B. In group A

14 cases were given 20-100 ng·kg

-1

·min

-1

of prostaglandin E

(PGE

) after the cardiopulmonary bypass (CPB) was stopped

and its velocity (dosage) was increased by 20 ng·kg

-1

·min

-1

every 10 minutes. When up to 100 ng·kg

-1

·min

-1

the velocity was held on for 10 minutes

then seized. PGE

was swapped when it was used for 1 h. Twenty-four hours later

7 cases of group A (A1) were given PGE

once more as the same as the day before; the other 7 cases (A2) were given normal saline instead as for controls. In group B

no cases were given PGE

during operation or on the day of operation. Twenty-four hours later

7 cases (B1) were given PGE

as that of A1

and the other 7 cases (B2) as that in group A2. In the hour of PGE

injection

the blood pressure (SABP

DABP

MABP)

pulmonary pressure (SPAP

DPAP

MPAP

PAWP)

systemic vascular resistance (SVR)

and pulmonary vascular resistance (PVR) were measured via Swan-Ganz catheter. Results There was not significant difference of parameters mentioned above between group A and group B. Twenty-four hours after operation

MPAP

PAWP and PVR in group C (A1+B1) were much lower than those in group D (A2+B2). Conclusion The effect of PGE

on pressure of pulmonary artery could not be seen when the patients were in anesthesia

so during mitral replacement operation it might be of some resistance.

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Related Institution

Department of High Altitude Physiology and Pathology

Department of High Altitude Special Drug and Equipment Research, Key Laboratory of High Altitude Medicine of PLA, College of High Altitude Military Medicine

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Institute of Cardiovascular Surgery, Xinqiao Hospital, Third Military Medical University

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Resistance to prostaglandin E1 in postoperative early stage of valvular replacement in rheumatic heart disease patients

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摘要

Abstract

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Keywords

references

Resistance to prostaglandin E₁in postoperative early stage of valvular replacement in rheumatic heart disease patients