Gerasimov N M, Guliamov D S, Karimova T Z, Belova O A, Ivanova L S, Nam L N
Anesteziol Reanimatol. 1994 May-Jun(3):14-7.
In 95 patients with hypervolemic congenital heart valve defects (42 with interventricular and interatrial septal defects, and 53 with patent ductus arteriosus) mixed venous blood levels of serotonin, histamine, adrenalin, noradrenaline, total 11-hydroxycorticosteroids were studied using spectrofluorimetry, cyclic adenosine- and guanosine monophosphate (cAMP and cGMP), prostaglandins E + A and F2 alpha and their interaction were assessed using radioimmunoassay and correlation analysis, respectively. Immediately after general anesthesia and surgical correction of septal defects using cardiopulmonary bypass adrenalin level was increased, while noradrenaline, cAMP, cGMP, prostaglandin E + A levels remained high. Similar pattern was observed in patients after arterial duct ligation. Mean pulmonary artery pressure was elevated in both groups of patients (above 4 kPa). Effective therapy of pulmonary hypertension with intravenous ATP infusions immediately after general anesthesia and elimination of septal defects (20 patients) was accompanied by a decline in noradrenaline, cGMP and total 11-hydroxycorticosteroid level (with adrenalin level increased), while after open arterial duct ligation (20 patients) it was followed by a drop in noradrenaline and prostaglandin F2 alpha level (with adrenalin level increased) and the activation of the interaction of biologically active substances aimed predominantly at attenuation of vasoconstrictor reactions in the lungs.
对95例血容量过多的先天性心脏瓣膜缺损患者（42例室间隔和房间隔缺损，53例动脉导管未闭），采用荧光分光光度法研究了混合静脉血中血清素、组胺、肾上腺素、去甲肾上腺素、总11 - 羟皮质类固醇的水平，分别采用放射免疫测定法和相关分析评估了环磷酸腺苷和环磷酸鸟苷（cAMP和cGMP）、前列腺素E + A和F2α及其相互作用。在全身麻醉并使用体外循环对间隔缺损进行手术矫正后，肾上腺素水平立即升高，而去甲肾上腺素、cAMP、cGMP、前列腺素E + A水平仍保持较高。在动脉导管结扎术后的患者中也观察到类似模式。两组患者的平均肺动脉压均升高（超过4 kPa）。在全身麻醉后立即对20例患者进行静脉输注ATP并消除间隔缺损，有效治疗肺动脉高压，同时去甲肾上腺素、cGMP和总11 - 羟皮质类固醇水平下降（肾上腺素水平升高），而在开放性动脉导管结扎术后（20例患者），去甲肾上腺素和前列腺素F2α水平下降（肾上腺素水平升高），生物活性物质相互作用激活，主要目的是减弱肺部的血管收缩反应。
