Ti Yun-xing, Pan Zheng-xia, Wu Chun
Department of Cardiovascular and Thoracic Surgery, Children's Hospital AfFiliated to Chongqing Medical University, Chongqing.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011 May;31(5):631-4.
To study the intervention of astragalus injection in the kidney injury of infants with congenital heart disease after cardiopulmonary bypass, thus providing a new method for protection of the kidney injury in them.
Forty infants undergoing cardiac surgery with cardiopulmonary bypass were randomly assigned to the test group and the control group, twenty in each group. Astragalus Injection (at the dose of 2 mL/kg) was added in the perfusion fluid before giving to infants in the test group before bypass, while the normal saline of the same volume was added in the perfusion fluid before giving to infants in the control group (P < 0.01). The concentrations of serum tumor necrosis factor-alpha (TNF)-alpha, interleukin-6 (IL-6), cystatin C (CysC), and N-acetyl-beta-D-glucosaminidase (NAG) were detected with ELISA at the following time points, i.e., before bypass (T1), by the end of the surgery (T2), 2 h after surgery (T3), 6 h after surgery (T4), and 24 h after surgery (T5).
The serum CysC concentrations were not significantly higher after CPB (P > 0.05). The urinary NAG level increased significantly in the control group after surgery (P < 0.05), but no obvious increase of the urinary NAG level was found in the test group after surgery (P > 0.05). It was obviously lower than that of the control group (P < 0.05). After CPB serum TNF-alpha and IL-6 levels increased significantly in the control group (P < 0.05), while they were lower in the test group than in the control group (P < 0.01).
CPB may result in the renal tubular injury in infants with congenital heart disease. The application of Astragalus Injection before the CPB plays a role in protecting renal tubular functions.
研究黄芪注射液对先天性心脏病患儿体外循环后肾损伤的干预作用，为保护其肾损伤提供新方法。
40例行体外循环心脏手术的婴儿随机分为试验组和对照组，每组20例。试验组在体外循环前于灌注液中加入黄芪注射液（剂量为2 mL/kg），对照组在灌注液中加入等体积的生理盐水（P<0.01）。于以下时间点，即体外循环前（T1）、手术结束时（T2）、术后2小时（T3）、术后6小时（T4）和术后24小时（T5），采用酶联免疫吸附测定法检测血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、胱抑素C（CysC）和N-乙酰-β-D-氨基葡萄糖苷酶（NAG）的浓度。
体外循环后血清CysC浓度升高不明显（P>0.05）。对照组术后尿NAG水平显著升高（P<0.05），试验组术后尿NAG水平无明显升高（P>0.05），明显低于对照组（P<0.05）。体外循环后对照组血清TNF-α和IL-6水平显著升高（P<0.05），试验组低于对照组（P<0.01）。
体外循环可导致先天性心脏病患儿肾小管损伤。体外循环前应用黄芪注射液对肾小管功能有保护作用。
