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目的 观察低温体外循环（ＣＰＢ）心内直视手术相中颅内静脉血中兴奋性氨基酸（ＥＡＡｓ）的变化及复温过程中应用异丙酚的作用。方法 择期心内直视手术病人３０ 例，随机分为对照组及观察组（复温过程中经人工心肺机注入异丙酚）。于麻醉诱导后ＣＰＢ前（Ａ）、降温３３℃时（Ｂ）、低温稳定期（Ｃ）、复温３３℃时（Ｄ）、复温开始后１ 小时（Ｅ）和２小时（Ｆ）经颈内静脉逆行置管取血样检测血浆ＥＡＡｓ浓度。结果 甘氨酸（Ｇｌｙ）两组Ｂ、Ｃ、Ｄ点值均明显高于Ａ 点；谷氨酸（Ｇｌｕ）对照组Ｄ点较Ａ点明显升高；天冬氨酸（Ａｓｐ）对照组Ｄ点较Ａ 点显著升高，并明显高于观察组。结论 体外循环心内直视手术中颅内静脉血ＥＡＡｓ浓度升高，复温过程中应用异丙酚可减少Ｇｌｕ、Ａｓｐ 水平的升高，但对Ｇｌｙ 无影响。
Objective To observe the changes of excitatory amino acids (EAAs) in intracranial venous blood of patients undergoing open heart surgery under hypothermic cardiopulmonary bypass (CPB) and the effect of propofol during rewarming. Methods Elective open heart surgery in patients with 30 cases, were randomly divided into control group and observation group (during rewarming by artificial heart-lung machine infusion of propofol). (C), 33 ℃ (D), 1 hour (E) and 2 hours (F) after the start of rewarming were observed before anesthesia induced CPB (A), 33 ℃ Blood samples were taken from the jugular vein retrograde catheter to detect plasma EAAs concentration. Results The values of B, C and D in glycine (Gly) group were significantly higher than those in A group, while the glutamate (Glu) group was significantly higher than that in A group. The As point in control group Point A significantly increased, and significantly higher than the observation group. Conclusion The concentration of EAAs in intracranial venous blood during cardiopulmonary bypass is increased. Propofol can reduce the levels of Glu and Asp during rewarming but have no effect on Gly.