心脏直视手术期间垂体前叶对促甲状腺激素释放激素的反应。

Anterior pituitary response to thyrotrophin-releasing hormone during open-heart surgery.

作者信息

Taylor K M, Wright G S, Bremner W F, Bain W H, Caves P K, Beastall G H

出版信息

Cardiovasc Res. 1978 Feb;12(2):114-9. doi: 10.1093/cvr/12.2.114.

DOI:10.1093/cvr/12.2.114

Abstract

The anterior pituitary response to thyrotrophin-releasing hormone has been studied in 20 patients submitted to elective open-heart surgical procedures, and in six control patients submitted to closed mitral valvotomy. Standard non-pulsatile normothermic perfusion was used in all the open-heart cases. 400 microgram thyrotropin-releasing hormone was administered by intravenous injection during bypass, at 30 min post-bypass, and at 60 min post-bypass. The same dose (400 microgram) was given during closed mitral valvotomy (Control Group). Thyrotrophin-releasing hormone administration during bypass failed to produce a normal response from the anterior pituitary, in contrast to the normal response pattern seen in the control group (P less than 0.01). Thyrotrophin-releasing hormone given after the period of bypass produced responses within the normal range in the majority of patients. These results suggest that anterior pituitary hypofunction may exist during the period of extracorporeal circulation using non-pulsatile perfusion and that recovery of pituitary function is evident within the first hour post-extracorporeal circulation.

摘要

对20例接受择期心脏直视手术的患者以及6例接受闭式二尖瓣切开术的对照患者，研究了垂体前叶对促甲状腺激素释放激素的反应。所有心脏直视手术病例均采用标准的非搏动性常温灌注。在体外循环期间、体外循环后30分钟和体外循环后60分钟，通过静脉注射给予400微克促甲状腺激素释放激素。在闭式二尖瓣切开术期间给予相同剂量（400微克）（对照组）。与对照组中所见的正常反应模式相比，体外循环期间给予促甲状腺激素释放激素未能使垂体前叶产生正常反应（P<0.01）。在体外循环期之后给予促甲状腺激素释放激素，大多数患者的反应在正常范围内。这些结果表明，在使用非搏动性灌注的体外循环期间可能存在垂体前叶功能减退，并且在体外循环后第一小时内垂体功能明显恢复。