外源性磷酸肌酸对冠状动脉搭桥病人围术期免疫系统的影响  

Perioperative influence of exogenous creatine phosphate on immune system in coronary artery bypass grafting

作　　者：潘玉春[1] 董培青[1] 姜乃德 管玉龙[1] 张振铃 袁慧[2] 

机构地区：[1]北京安贞医院体外循环科,100029 [2]北京安贞医院免疫室,100029

出　　处：《中华胸心血管外科杂志》2000年第2期87-89,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　观察用外源性磷酸肌酸 (CP)对冠状动脉搭桥 (CABG)病人围术期补体及免疫球蛋白的变化 ,评价其对免疫系统的影响。方法　 2 8例CABG病人随机分为CP组 17例 ,对照组 11例。CP组于术前、后各用CP 3～ 7d ,每天 2g静脉滴注 ,术中将CP加入心脏停搏液中 ;对照组术前、中、后均不用CP。观察两组病人术前 1周、麻醉诱导后、术中阻断升主动脉后 5、35、6 5min(14例病人 )、术毕、术后 2 4h、术后 1周共 8个时点补体 (C3 、C4 )及免疫球蛋白 (IgA、IgG、IgE、IgM)的变化。结果　两组病人补体C3 、C4 及 4种免疫球蛋白的变化曲线相似 ,仅术后 1周结果显示CP组补体C3 、C4 及免疫球蛋白IgG、IgM均明显低于对照组 (P <0 0 5 ) ,其他 7个时点两组间均无明显差别。结论　外源性磷酸肌酸用于CABG病人围术期 ,对补体及免疫球蛋白有较好的保护作用 ,可能减少病人术后炎症反应等并发症 ,利于手术病人恢复。Objective To evaluate the Perioperative influence of exogenous creatine phosphate (CP) on immune system in coronary artery bypass grafting by observing the changes of completment and immunoglobulin. Method 28 patients were divided into control group (n=11) and CP group (n=17). In the CP group, CP was given perioperatively (2g/day intravenously for 3(7days) and during operation (10 mmol/L added into cardioplegia). In the control group, no CP was given. The changes of completment (C3, C4) and immunoglobulin (IgA, IgG, IgE, IgM) were documented at eight different time intervals. Results The trends of changes were similar in both groups. In CP group, all values were lower, especially the values of C3, C4, IgG, IgM. The perioperative and early postoperative values showed no significant difference with exception of those at 1 week after operation (P<0.05). Conclusion the data indicates that exogenous creatine phosphate used in the patients of CABG perioperatively may have protective effect on complement and immunoglobulin, the definitive mechanism is not clear, and needs further study.

关 键 词：外源性磷酸肌 冠状动脉搭桥术 免疫系统 

分 类 号：R654.2[医药卫生—外科学]