体外及非体外循环冠状动脉搭桥术对血清磷酸肌酸激酶同工酶和心肌钙蛋白的影响  

A comparison of serum creatine kinase-MB and cardiac troponin I in patients undergoing CABG with off-pump technique or cardiopulmonary bypass

作　　者：张孟元[1] 王波[1] 徐艳冰[1] 李刚[1] 

机构地区：[1]山东大学山东省立医院麻醉科,山东济南250021

出　　处：《山东大学学报（医学版）》2007年第2期139-141,共3页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨体外循环心脏停跳下冠状动脉搭桥术(CPB-CABG)与非体外循环心脏不停跳冠状动脉搭桥术(OPCABG)对心肌损伤的影响。方法:选择60例择期行冠状动脉搭桥术的冠心病患者,按是否应用心肺转流(CPB)随机分为体外循环组(CPB-CABG组,n=30)和非体外循环组(OPCABG组,n=30)。于术前、术后2、62、4 h采集血标本,Olympus AU1000全自动生化分析仪测定检测血清磷酸肌酸激酶同工酶(CK-MB);ELISA法测定心肌钙蛋白(cTnI)含量。结果:术前两组间各项指标差异均无统计学意义(P>0.05)。但两组术后2、62、4 h各时点pCK-MB、cTnI均较术前明显升高(P<0.01或P<0.05)。与CPB-CABG组相比,OP-CABG组术后2、62、4 h各时点CK-MBc、TnI明显降低(P<0.05)。结论:与体外循环心脏停跳下冠状动脉搭桥术相比,非体外循环心脏不停跳冠状动脉搭桥术能显著减轻对心肌的损伤。Objective： To examine the circulating levels of creatine kinase-MB and cardiac troponin I （cTnI） following coronary artery bypass graft（CABG） surgery by either standard cardiopulmonary bypass （CPB） or the ＇octopus technique＇ on a beating heart. Methods： Sixty patients with coronary heart disease （CHD） undergoing CABG surgery were randomly divided into two groups （ n = 30）： the OPCABG group, which received off-pump CABG and the CPBCABG group, which received CPB. Blood samples were obtained prior of the operation and at the 2nd, 6th, 24th h after the end of the operation. The serum creatine kinase-MB（CK-MB） and the cardiac troponin I （cTnI） were determined. Results： In both groups, the CK-MB and cTnI levels were significantly increased at the post-operative 2nd, 6th, 24th h compared with those before the operation（ P 〈0.01 or P 〈0.05）. Compared with those of the CPB-CABG group, the CK-MB and cTnI of the OPCABG group were markedly decreased at the 2nd,6th,24th h after the operation（ P 〈0.05）. Con- clusion： These data demonstrate that off-pump CABG has a greater protective effect on myocardial injury than CPB-CABG.

关 键 词：磷酸肌酸激酶同工酶 心肌钙蛋白 心肺转流 跳动心脏 冠状动脉搭桥术 

分 类 号：R654.2[医药卫生—外科学]