Study On The Changes Of C-type Natriuretic Peptide And Endothelin-1 Levels In Plasma During Cardiopulmonary Bypass In Patients With Congenital Heart Disease

Objective: To detect plasma C-type Natriuretic Peptide(CNP) and Endothelin-l(ET-l) levels during Cardiopulmonary Bypass(CPB) and analyze reasons of dynamic changes.Methods: By using radio-immunossary, plasma levels of CNP and ET-1 of 48 patients with Congenital Heart Disease (CHD) were measured at pre-operation, 30min post-CBP, 30min post-declamp of aorta, 6h post-operation and 24h post-operation respectively during CPB.Results: The plasma CNP levels decreased markedly at 30minpost-CBP ( 138.6±39.2 pg/ml) and 30min post-declamp of aorta(148.1±38.2pg/ml) compared with pre-operation (204.9±66.0pg/ml)(P<0.01) . However, till 6h post-operation (209.5±70.6 pg/ml) theCNP increased significantly compared with 30min post-CBP and 30minpost-declamp of aorta (P<0.05) . Then it decreased significantly at 24hpost-operation (153.6±41.2 pg/ml) ( P < 0.05 ) compared with 6hpost-operation and was closed to the normal group (168.46±59.2 pg/ml) .Mean level of ET-1 at 30min post-CBP (18.0±27.0pg/ml) and 30minpost-declamp of aorta (16.98+ 14.05pg/ml) was lower than that atpre-operation (27.7±17.2pg/ml) ,and there was statistic differences ( P < 0.01 ) . At 6h post-operation(22.4±16.6) ET-1 increased significant (P<0.05) and was closed to the normal group (44.34±19.1pg/ml) .Conclusion: At early stage of CHD, the plasma ET-1 level may bebeneficial to maintain normal heart-vessel function during CPB.Meanwhile, the external CNP is an effective agent to prevent the injuryof myocardiocytes.