te Velthuis H, Jansen P G, Oudemans-van Straaten H M, van Kamp G J, Sturk A, Eijsman L, Wildevuur C R
Centre for Cardiopulmanary Surgery and Amsterdam, Vrije Universiteit Hospital, Amsterdam, Netherlands.
Ann Thorac Surg. 1996 Mar;61(3):904-8. doi: 10.1016/0003-4975(95)01187-0.
Endothelin is involved in the control of cardiovascular and renal functions and acts as a neuromodulator.
In a prospective study among 15 male patients who underwent coronary artery bypass grafting, we investigated the release pattern and possible stimuli of circulating endothelin.
We detected a steep increase in endothelin concentrations after the onset of cardiopulmonary bypass (CPB), and a second minor increase during CPB. The steep increase in endothelin concentrations correlated with the change in arterial pressures at the onset of CPB (r = -0.57; p < 0.03). The slow increase in endothelin concentrations during CPB, however, correlated with mean endotoxin levels during and after CPB (r = 0.60; p < 0.02).
The change in arterial pressure at the onset of CPB seems to induce a steep and fast increase in circulating endothelin level, which is probably mediated through the baroreceptors. The slow increase in endothelin level during CPB is associated with increased circulating endotoxin concentration. It may be that either endothelin-mediated vasoconstriction induces endotoxin transmigration from the intestine or endotoxin stimulates secretion from endothelial cells.
内皮素参与心血管和肾脏功能的调控，并作为一种神经调节剂发挥作用。
在一项对15例行冠状动脉旁路移植术的男性患者的前瞻性研究中，我们调查了循环内皮素的释放模式及可能的刺激因素。
我们检测到体外循环（CPB）开始后内皮素浓度急剧升高，并且在CPB期间有第二次较小幅度的升高。内皮素浓度的急剧升高与CPB开始时动脉压的变化相关（r = -0.57；p < 0.03）。然而，CPB期间内皮素浓度的缓慢升高与CPB期间及之后的平均内毒素水平相关（r = 0.60；p < 0.02）。
CPB开始时动脉压的变化似乎诱导循环内皮素水平急剧快速升高，这可能是通过压力感受器介导的。CPB期间内皮素水平的缓慢升高与循环内毒素浓度升高有关。可能是内皮素介导的血管收缩诱导内毒素从肠道迁移，或者内毒素刺激内皮细胞分泌。
