体外与非体外循环冠状动脉旁路移植术围术期炎症细胞因子与肌钙蛋白的变化及意义  

Changes in content of inflammatory cytokines and troponin I in peri-operative periods of coronary artery bypass grafting with or without cardiopulmonary bypass

作　　者：黄志勇[1] 姚滨[1] 蒋红英[2] 徐名新[3] 

机构地区：[1]深圳市孙逸仙心血管医院麻醉科,518000 [2]深圳市妇幼保健院儿科 [3]深圳市孙逸仙心血管医院检验科,518000

出　　处：《中国危重病急救医学》2005年第3期168-170,共3页Chinese Critical Care Medicine

基　　金：广东省深圳市科研基金重点资助项目 (2 0 0 40 413 2 )

摘　　要：目的　探讨体外与非体外循环下行冠状动脉旁路移植术 (CABG)对患者围术期炎性反应及心肌损伤的影响。方法　 6 0例行择期 CABG患者 ,随机分成体外循环下行 CABG组 (CCABG组 ,30例 )和非体外循环下行 CABG组 (OPCABG组 ,30例 ) ,分别于术前和术后 2、8、2 4、4 8h抽取中心静脉血 ,检测白细胞介素 6 (IL 6 )、IL 8、肿瘤坏死因子 α(TNFα)、肌酸激酶同工酶 (CK MB)、肌钙蛋白 I(c Tn I)等 ,并记录术后早期的各项临床指标。结果　 CCABG组术后早期 IL 6、IL 8、TNFα、CK MB及 c Tn I均明显高于术前及 OPCABG组 ,OPCABG组患者手术过程中大部分指标无明显变化。结论　与 CCABG组相比 ,OPCABG组患者全身炎性反应及心肌损伤程度均明显减轻。Objective To evaluate the effects of coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass (CPB) on inflammatory response and myocardial injury. Methods Sixty patients undergoing elective CABG were randomly divided into CABG with CPB group (CCABG, 30 cases) and CABG without CPB group (OPCABG, 30 cases). Blood samples were collected from central vein to assay interleukin6 (IL6), interleukin8 (IL8), tumor necrosis factorα (TNFα), MB isoenzyme of creatine kinase (CKMB) and troponin I (cTnI) before operation and 2, 8, 24, as well as 48 hours after operation , and all clinical data of the patients were recorded accordingly. Results After operation, the contents of IL6, IL8, TNFα, CKMB and cTnI were significantly higher in CCABG group than those before operation and those in OPCABG group , while most of these parameters showed little change in OPCABG group both in operative or postoperative period. Conclusion The results suggest that OPCABG may provide better myocardial protection and less systemic inflammatory response than CCABG.

关 键 词：体外循环 冠状动脉旁路移植术 围术期 炎症细胞因子 肌钙蛋白 

分 类 号：R654.2[医药卫生—外科学]