Inoue S, Hayashi Y, Ohnishi Y, Kikumoto K, Minamino N, Kangawa K, Matsuo H, Furuya H, Kuro M
Department of Anesthesiology, National Cardiovascular Center, Osaka, Japan.
Anesth Analg. 1999 May;88(5):1030-5. doi: 10.1097/00000539-199905000-00011.
Adrenomedullin is a potent vasodilatory peptide originally identified in human pheochromocytoma. Plasma adrenomedullin increases during and after cardiopulmonary bypass (CPB). However, the site at which production of adrenomedullin is augmented has not been identified. In the present study, we examined the contribution of the cerebral vasculature to the production of adrenomedullin in patients before, during, and after CPB. Ten patients undergoing coronary artery bypass grafting with mild hypothermic CPB were studied. Cerebral blood flow was measured using the Kety-Schmidt method before, during, and after CPB. Plasma adrenomedullin concentrations from radial artery and internal jugular bulb blood were measured by radioimmunoassay, and cerebral adrenomedullin production was evaluated. Adrenomedullin production in the cerebral vasculature was significantly enhanced after CPB and correlated with aortic cross-clamping time. The cerebral adrenomedullin production may contribute to the increased plasma level of adrenomedullin after CPB.
Plasma adrenomedullin has been reported to increase in humans after cardiac surgery involving cardiopulmonary bypass. In this study, we demonstrated that cerebral adrenomedullin production may contribute to the increased plasma level of adrenomedullin after cardiopulmonary bypass.
肾上腺髓质素是一种强效血管舒张肽，最初在人嗜铬细胞瘤中被鉴定出来。在体外循环（CPB）期间及之后，血浆肾上腺髓质素会升高。然而，肾上腺髓质素产生增加的部位尚未确定。在本研究中，我们检测了CPB术前、术中和术后患者脑血管系统对肾上腺髓质素产生的作用。研究了10例接受轻度低温CPB冠状动脉旁路移植术的患者。在CPB术前、术中和术后使用凯蒂-施密特方法测量脑血流量。通过放射免疫分析法测量桡动脉和颈内静脉球部血液中的血浆肾上腺髓质素浓度，并评估脑肾上腺髓质素的产生情况。CPB术后脑血管系统中肾上腺髓质素的产生显著增强，且与主动脉阻断时间相关。脑肾上腺髓质素的产生可能导致CPB术后血浆肾上腺髓质素水平升高。
据报道，在涉及体外循环的心脏手术后，人类血浆肾上腺髓质素会升高。在本研究中，我们证明脑肾上腺髓质素的产生可能导致体外循环后血浆肾上腺髓质素水平升高。
