体外循环前后患者血浆基质金属蛋白酶-9浓度及激活程度的变化  

The effects of cardiopulmonary bypass on matrix metalloproteinase 9 gene expression and plasma concentration in human cardiac procedure patients

作　　者：王寿勇[1] 张诗海[1] 姚尚龙[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,湖北省武汉市430022

出　　处：《中国心血管病研究》2005年第9期648-650,共3页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金资助项目(30271255)

摘　　要：目的研究体外循环前后患者血浆基质金属蛋白酶-9(MMP-9)浓度和激活程度的变化。方法拟行心内直视手术的成年患者20例为体外组,同期行其他开胸手术的成年患者8例为对照组。所有患者均采用芬太尼静脉复合麻醉。体外组患者在肝素化后常规建立体外循环,以2.2￣2.4L/(m2·min)恒流灌注,体外循环期间维持鼻温27℃～29℃。分别在手术开始前、转流开始前和停机成功后取血液标本2ml,肝素抗凝,分离出血浆,分装并置于-20℃冰箱中保存。对照组患者的采血时间为手术开始前、进胸后和关胸时,标本处理和保存方法同体外组。全部标本均测定血浆总MMP-9浓度和活性MMP-9浓度,计算MMP-9激活程度。结果体外组患者血浆总MMP-9、活性MMP-9浓度及其激活程度于停机成功后高于对照组(对照组为关胸时)(P<0.01);与手术开始前比较,体外组患者上述指标于停机成功后显著升高(P<0.01),而对照组各时点间差异无统计学意义(P>0.05)。结论体外循环可导致患者血浆MMP-9浓度和激活程度显著升高。Objective To investigate the changes of concentrations and activities of matrix metalloproteinase 9 in plasma of patients undergoing cardiopulmonary bypass. Methods Twenty patients subjected to thoracotomy followed by moderate hypothermic cardiopulmonary bypass were enrolled as cardiopulmonary bypass group. Another 8 patients undergoing thoracic surgery without cardiopulmonary bypass were selected as control group. Two milliliter of venous blood was collected at the time points of pre-operation, just before start-up of cardiopulmonary bypass and ending cardiopulmonary bypass in the cardiopulmonary bypass group, and at time points of pre-operation, opening and closing thoracic cavity in the control group, respectively, then platelet-free plasma was separated. Concentration of total and active matrix metalloproteinase 9 in plasma was measured using enzyme-linked immunoadsorbent assay or fluorometric enzyme-linked immunoadsorbent assay. Results At the time point of ending cardiopulmonary bypass, the plasma level of total and active metalloproteinase 9 of the cardiopulmonary bypass group is higher than pre-operation. And they also show significant increasing compared with the control （at closed thoracic cavity）. Conclusion Cardiopulmonary bypass leads to significant increase of both the total and active matrix metalloproteinase 9 in plasma.

关 键 词：心肺转流术 明胶酶B 蛋白质工程 血浆基质金属蛋白酶-9 体外循环期间 患者血浆 基质金属蛋白酶-9(MMP-9) 浓度 激活 心内直视手术 

分 类 号：R654.1[医药卫生—外科学] R541.6[医药卫生—临床医学]