Royston D, Minty B D, Higenbottam T W, Wallwork J, Jones G J
Ann Thorac Surg. 1985 Aug;40(2):139-43. doi: 10.1016/s0003-4975(10)60006-9.
We measured the rate of clearance of technetium 99m-labeled diethylenetriamine pentaacetate (99mTcDTPA) (molecular weight, 492 daltons) from the lung into the blood (T1/2LB) in 9 patients before and after operation with cardiopulmonary bypass (CPB). Two hours postoperatively, T1/2LB fell from 49.3 +/- 13.6 minutes (mean +/- standard deviation) to 24.0 +/- 12.8 minutes (p less than 0.001). In addition, alveolar-arterial oxygen tension difference P(A-a)O2 had increased from 73 +/- 28 mm Hg to 164 +/- 37 mm Hg (p less than 0.001). The rates of clearance of 99mTcDTPA had returned to preoperative times by 7 days after operation, although there was still a significant (p less than 0.05) elevation in P(A-a)O2. Postoperative respiratory failure developed in 1 patient. The only abnormality of lung function detected preoperatively was an increased clearance rate for 99mTcDTPA (T1/2LB, 18 minutes). This study has shown an increased clearance from the lung of a low-molecular-weight molecule following operation with CPB. This finding should allow a more rational approach to elucidating the mechanisms of injury to the gas-blood interface in the lung following this type of operation.
我们在9例接受体外循环（CPB）手术的患者术前和术后测量了锝99m标记的二乙三胺五乙酸（99mTcDTPA，分子量492道尔顿）从肺到血液的清除率（T1/2LB）。术后两小时，T1/2LB从49.3±13.6分钟（均值±标准差）降至24.0±12.8分钟（p<0.001）。此外，肺泡-动脉氧分压差P(A-a)O2从73±28mmHg升至164±37mmHg（p<0.001）。术后7天时，99mTcDTPA的清除率已恢复至术前水平，尽管P(A-a)O2仍有显著升高（p<0.05）。1例患者术后发生呼吸衰竭。术前检测到的唯一肺功能异常是99mTcDTPA清除率增加（T1/2LB，18分钟）。本研究显示，CPB手术后肺内低分子量分子的清除增加。这一发现应有助于更合理地阐明此类手术后肺气血界面损伤的机制。
