|
Objective: Deep hypothermic circulatory arrest (Deep Hypothermia Circulatory Arrest, DHCA) is mainly used in surgery involving the aortic arch complex congenital heart disease, and aortic dissection, it can increase brain tolerance to ischemia, hypoxia time, provide a blood \Study, DHCA induced complications of the central nervous system and brain vascular endothelial cell injury. Endothelial progenitor cells (Endothelial Progenitor Cells, EPCs) to cause the attention of scholars at home and abroad because of its angiogenesis and vascular endothelial repair. This study investigated the impact of the level of DHCA congenital heart disease associated with pulmonary hypertension in infants circulating EPCs (circulating-EPCs, c-EPCs), to provide the basis for later research. Methods: July 2010 to December 2010, 30 cases of congenital heart disease with pulmonary hypertension in infants and young children in the moderate, aged 2 months to 36 months. Simple cardiopulmonary bypass (Cardiopulmonary bypass, CPB) surgery transit flow way into the group and DHCA regional cerebral perfusion (Regional Cerebral Perfusion, the RCP) group. Of anesthesia (T1), the CPB completion (T2), postoperative 4h (T3), postoperative 24h (T4) and postoperative 48h (T5) to extract the children with arterial flow cytometry c-EPCs to 200,000 peripheral blood mononuclear cells CD34 of CD133 double positive cells quantify the level of c-EPCs. Records of the CPB time intraoperative children ascending aorta clamping time, with DHCA the RCP time to and postoperative awake time, ventilator support time and ICU stay. By analyzing the differences in the levels of the two different c-EPCs, to explore a possible link between DHCA impact of congenital heart disease with pulmonary hypertension in children with the level of c-EPCs and c-EPCs postoperative recovery. Results: 1. Mere CPB group at T1, T2, T3, T4 and T5 at each time point the level of c-EPCs were 62.06 ± 20.24,37.50 ± 15.79,124.39 ± 44.91,18.33 ± 12.15 and 31.67 ± 10.93; with DHCA RCP group T1, T2, T3, T4 and T5 at each time point the level of c-EPCs were 69.00 ± 41.11,24.92 ± 15.87,78.00 ± 48.92,30.42 ± 23.17 28.33 ± 11.40. The groups T2, and T4, the the T5 time points c-EPCs water average significantly lower than the time T1 (P LT; 0.05 or P LT; 0.01). Simple the CPB set of T3 point in time the level of c-EPCs significantly higher than at T1 (P lt; 0.05), the level of c-EPCs with DHCA the RCP group of T3 point in time is slightly higher than at T1, but no statistical significance (P gt; 0.05 ). Between the two groups the level of c-EPCs T1, T4, T5 point in time the difference was not statistically significant (P gt; 0.05); at T2, T3 point with DHCA the RCP group of c-EPCs levels significantly lower than those in CPB group ( P lt; 0.05). 3.DHCA RCP group T2 time point the level of c-EPCs CPB time was a negative correlation (r = -0.621, P lt; 0.05), with the the DHCA RCP time was a negative correlation (r = -0.965, P lt; 0.01) correlation is statistically significant. The the T2 point in time of the the DHCA RCP group the level of c-EPCs ascending aorta clamping time was negatively correlated, but the correlation was not statistically significant (r = -0.382, P gt; 0.05). 4.DHCA RCP group T2 time point the level of c-EPCs with postoperative awake time, ventilator support time and ICU stay time showed a negative correlation (r = -0.625, r = -0.647 and r = -0.642), correlation were statistically significant (P lt; 0.05). Conclusion: the pure CPB and DHCA can be caused by congenital heart disease with pulmonary hypertension after infant level of c-EPCs reduce the level of c-EPCs, and DHCA greater impact.
|