乌司他丁对体外循环冠状动脉搭桥术后早期房颤的影响  

Effect of Ulinastatin on Early Atrial Fibrillation after Coronary Artery Bypass Grafting with Cardiopulmonary Bypass

作　　者：王成立[1] 刘付宁[1] 刘玲[1] 梁建军[1] 吴佳瑶[2] 曹铭辉[1] 

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,510120 [2]河北省邯郸市第一医院麻醉科

出　　处：《岭南急诊医学杂志》2015年第1期15-16,53,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的 :观察术中应用乌司他丁(UTI)对体外循环冠状动脉搭桥术后(CABG)早期房颤(AF)发生率的影响。方法:114例拟行冠脉搭桥术患者随机分为UTI治疗组(U组,n=57)和对照组(C组,n=57)。U组在麻醉诱导后开始恒速静脉泵入1万U/kg,30 min输入完毕,C组以同样方法输入相同剂量的生理盐水。分别于麻醉诱导前(T1)及术后24 h(T2)抽取患者静脉血检测血白细胞、中性粒细胞和淋巴细胞,测定血浆IL-6、CRP浓度,同时行术后24 h动态心电图监测。结果:与C组相比,U组术后24 h内AF发生率显著降低(P<0.05);与T1比较,U组术后24 h的NLR显著降低(P<0.01),C组NLR显著增加(P<0.01);而C组和U组的IL-6、CRP与T1比较无明显改变。结论:UTI可降低体外循环CABG 24h内AF的发生率,机制可能与其降低手术应激产生的炎症反应有关。Objective ： To explore the effect of ulinastatin（UTI） on early atrial fibrillation（AF）after coronary artery bypass grafting with cardiopulmonary bypass（CABG）. Methods：114 patients undergoing CABG with cardiopulmonary bypass were randomly divided into ulinastatin group（group U,n=57） and control group（group C,n=57）.In group U,10000 U / kg of intravenous UTI was administered after anesthetic induction, in group C, equal volume of saline placebo was infused within 30 mins. Blood samples were obtained for the measurements of white blood cells and neutrophils / lymphocytes（NLR） before the anesthesia（T1）, 24 h after CABG（T2）. Plasma IL-6 and C-reactive protein were measured. 24 postoperative hours Holter recording was performed at the same time. Results ： The rate of AF was significantly declined（P〈0.05） in group U after CABG compared with group C. The NLR in group U was significantly decreased（P〈0.01） compared with preoperation in T2. However, the NLR in group C was deeply increased（P〈0.01） compared with preoperation in T2. There were no significant differences about IL-6 and CRP in the two groups compared with preoperation. Conclusion ： Administration of UTI can decrease the rate of AF after CABG, which the mechanism may be the decrease of inflammation.

关 键 词：乌司他丁 冠状动脉搭桥术 房颤 中性粒细胞与淋巴细胞比值 

分 类 号：R654.2[医药卫生—外科学]