目的 通过测量围术期先天性心脏病患儿重复内皮祖细胞(EPCs)数量,明确体外循环(ECC)对循环EPCs的影响.方法 2010年7月到2010年12月外科治疗先天性心脏病伴肺动脉高压患儿40例,分为非ECC组和ECC组,每组 20例.非ECC组在非ECC下行胸部小切口直视封堵和动脉导管未闭结扎术; ECC组在经典ECC下行各种心脏畸形矫正手术.两组患者分别于麻醉前(T1)、手术后即刻(T2)、术后4 h(T3)、24 h(T4)、72 h(T5)抽取患儿桡动脉血,通过流式细胞仪测定外周血中EPCs数量.分析ECC对循环EPCs的影响.结果 两组患儿T1时间EPCs无显著差异(P>0.05);在T3时间点ECC组患儿循环EPCs数高于非ECC组,差异有统计学意义(P<0.01);术后T2、T4、T5时间点ECC组循环EPCs数均低于非ECC组和T1时间EPCs数,结果有统计学意义(P<0.01).结论 ECC可以导致术后循环EPCs水平的降低.%Objective This study was Incus to observe the influence of extrarorporeal circulation ( ECC ) on circulating endothelial progenitor cells ( EPCs ) in infants with congenital heart disease by measuring the EPCs amount. Methods Between July 2010 and December 2010, 40 infants with congenital heart disease and pulmonary arterial hypertension were divided into ECC group and off — pump group. In off — pump group, 20 cases received ligation of patent ductus arteriosus and closure of art rial sepectal defect without cardio pul mo nary bypass. In ECC group, 20 cases had open heart operations with cardio pulmonary bypass. The amount of circulating EPCs counted by flow cytometer at anesthesia completion ( T1 ), the end of surgery ( T2 ), 4 h ( T3 ), 24 h ( T4 ) and 72 h ( T5 ) after operations. The relation of ECC and EPCs amount was analyzed. Results The amount of circulating EPCs in the two groups had no statistically significant differences at T1( P ＞0. 05 ). The amount of circulating EPCs in ECC group was significantly higher than that in off —pump group at T3 ( P ＜0. 01 ). The amount of circulating EPCs at T2, T4, T5 in ECC group was significantly lower than that at Tl and those time points in off - pump group ( P ＜0.01 ). Conclusion The levels of circulating EPCs reduce after ECC.
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