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本文应用兔体外循环（ＣＰＢ）模型研究ＣＰＢ中糖皮质激素受体（ＧＲ）的变化及早期应用大剂量糖皮质激素（ＧＣ）的效应。结果发现，兔胸腺高亲和力ＧＲ数目在ＣＰＢ６０ｍｉｎ较ＣＰＢ前显著下降（－３５％），ＣＰＢ中血浆ＧＣ浓度显著升高，同时伴有血浆磷脂酶Ａ２（ＰＬＡ２）活性和肺血管外含水量（ＥＶＬＷ／ＢＦＤＬ）显著升高；在ＣＰＢ前５ｍｉｎ静注琥珀酸钠氢化考的松２０ｍｇ／ｋｇ，虽使胸腺ＧＲ水平进一步下降（－６９％），但能显著提高ＣＰＢ期间血浆ＧＣ浓度，并能显著抑制血浆ＰＬＡ２活性和ＥＶＬＷ／ＢＦＤＬ的升高。提示ＣＰＢ能引起ＧＲ水平下降，从而降低ＧＣ效应；ＣＰＢ术中早期应用大剂量ＧＣ能在ＣＰＢ中ＧＲ减少的情况下维持或提高ＧＣ的效应，但其作用很可能并非完全通过高亲和力ＧＲ介导。
In this paper, CPB model was used to study the changes of glucocorticoid receptor (GR) in CPB and the effects of early high-dose glucocorticoid (GC). The results showed that the number of high affinity GR of thymus in rabbits decreased significantly (P <0.05) before CPB at 60 min, the concentration of plasma GC increased significantly in CPB accompanied by the activity of plasma PLA2 and the extravascular water content (EVLW / BFDL). In the first 5 minutes of CPB, hydrocortisone acetate 20mg / kg, while the thymus GR levels decreased further (-69%), but significantly increased plasma GC concentration during CPB, and can significantly Inhibition of plasma PLA2 activity and EVLW / BFDL elevation. Suggesting that CPB can reduce the level of GR, thereby reducing the GC effect; early use of high-dose GC in the treatment of CPB can reduce or reduce the GR in the case of GC to maintain or enhance the effect of GC, but its role may not be fully mediated by high affinity GR .