#40#中国中西医结合杂志2009年1月第29卷第1期CJITWM,January2009,Vo.l29,No.1银杏叶提取物对心脏围手术期患者血管内皮生长因子的影响邓云坤韦方安邦权刚绍鹏陈静吴大庆摘要目的探讨银杏叶提取物(金纳多)心停跳液对围手术期血浆血管内皮生长因子(VEGF)水平的影响及其临床意义。方法20例心脏手术患者采用数字表法随机均分为两组,对照组(10例)常规建立体外循环(CPB),阻断升主动脉后经主动脉根部顺灌4eStThomasc停搏液(15mL/kg);银杏叶组(10例):在4eStThomasc停搏液中加入金纳多(015mg/kg),余同对照组。麻醉诱导前后、主动脉插管后转机前、主动脉阻断015h、主动脉开放015h、术毕即刻、术后6h、术后24h分别取桡动脉血2mL采用酶联免疫吸附法(ELISA)测定VEGF浓度。结果对照组VEGF浓度在主动脉阻断015h开始上升,术后6h达到高峰(P<0101);银杏叶组在主动脉阻断015h时已达高峰(P<0101),主动脉开放015h时开始下降。结论金纳多可诱导VEGF生成,这可能是其心肌保护的机制之一。关键词银杏叶提取物;血管内皮生长因子;体外循环EffectofGinkgoBilobaExtractonPlasmaVascularEndothelialGrowthFactorduringPer-ioperativePer-iodofCardiacSurgeryDENGYun-kun,WEIFang,ANBang-quan,etalDepartmentofAnesthesiology,GuizhouProvincialPeoplecsHospital,Guiyang(550002)ABSTRACTObjectiveToinvestigatetheeffectandclinicalvalueofginkgobilobaextract(Ginaton)ontheplasmavascularendothelialgrowthfactor(VEGF)inpatientsduringper-ioperativeperiodofcardiacsurgery.MethodsTwentypatientsscheduledtoreceivecardiacoperationwererandomlyassignedto2groupsbyadigitaltable.Forthe10patientsinthecontrolgroup,thecardiopumlonarybypass(CPB)wasestablishedinroutineandreceivedcold(4e)StThomasccardioplegiaperfusion(15mL/kg)viaaorticrootafterascendingaortablocking,asforthe10patientsintheGinatongroup,thesamewasdonebutwith015mg/kgofGinatonaddedtothecardioplegiaperfusion.PlasmaVEGFcontentsweredetectedbyELISAatdifferenttmiepoints,.ie.beforeandafteranesthesiainduction(T1,T2),afteraortaintubation(T3),015hafteraortaclamping(T4),015ha-fteraortadeclamping(T5),mimediateafterterminatingtheoperation(T6),6hafteroperation(T7),and24hafteroperation(T8).ResultsInthecontrolgroup,VEGFlevelbegantoriseatT4andreachedthepeakatT7(P<0101),whileintheGinatongroup,itreachedthepeakearlyatT4(P<0101),andbegantodropatT5(P<0101)1ConclusionGinatoncouldinducetheproductionofVEGF,whichmaybeoneofthemechanismsforitsmyocardialprotection.KEYWORDSGinkgobilobaextrac;tvascularendotheliumgrowthfactor;cardiopumlonarybypass血管内皮生长因子(vascularendothelialg