心脏型脂肪酸结合蛋白在停跳与不停跳冠状动脉旁路移植术围术期变化的研究  

Change of heart-type fatty acid binding protein during on-pump and off-pump coronary artery bypass grafting

作　　者：王洋[1] 柳克晔[1] 韩喆[1] 罗志强[1] 刘福林[1] 

机构地区：[1]河北大学附属医院河北省医学重点学科心脏外科,保定071000

出　　处：《中华老年心脑血管病杂志》2015年第5期495-497,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省科技厅科技研究与发展计划项目(11276103D-76)

摘　　要：目的研究心脏型脂肪酸结合蛋白(H-FABP)及肌钙蛋白I(cTnI)等在体外循环及非体外循环冠状动脉旁路移植术中与心肌损伤的关系。方法将冠状动脉旁路移植术的55例患者随机分为体外循环组25例和非体外循环组30例,肝素化前,体外循环组在主动脉开放后1、2、4、8、24、48和72h,非体外循环组在最后1支血管远心端吻合后相同时间点采血10ml,检测H-FABP、cTnI及肌酸激酶同工酶(CK-MB)等,并记录临床指标变化。结果与非体外循环组比较,体外循环组总H-FABP[(95.42±60.48)μg/L vs(3.91±1.46)μg/L,P=0.000]水平显著升高,且H-FABP在术后1h及达顶峰值,早于cTnI及CK-MB。结论非体外循环冠状动脉旁路移植术式心肌损伤程度较体外循环术式小;围术期H-FABP检测有助于围术期心肌损伤的早期诊断。Objective To study the association of heart-type fatty acid binding protein（H-FABP）and cTnI with myocardial injury during on-pump and off-pump CABG.Methods Fifty-five patients undergoing CABG were randomly divided into on-pump CABG group（n=25）and off-pump CABG group（n=30）.The serum levels of H-FABP,cTnI,and CK-MB were measured in onpump CABG group at 1,2,4,8,24,48 and 72hafter aortic unclamping and in off-pump CABG group at the same time points after the last distal anastomosis.Results The serum H-FABP level was significantly higher in on-pump CABG group than in off-pump CABG group（95.42±60.48μg/L vs 3.91±1.46μg/L,P=0.000）and reached its peak 1hafter declamping,which was earlier than those of cTnI and CK-MB.Conclusion Myocardial injury is milder in off-pump CABG than in on-pump CABG.H-FABP contributes to its early diagnosis.

关 键 词：脂肪酸结合蛋白质类 冠状动脉旁路移植术 非体外循环 体外循环 

分 类 号：R654.2[医药卫生—外科学]