体外及非体外循环冠状动脉搭桥术对心型脂肪酸结合蛋白的影响  

Comparison of heart-type fatty acid-binding protein in on-pump versus off-pump coronary artery bypass grafting

作　　者：栗志勇[1] 常俊伟 张悟麟[1] Li Zhi-yong;Chang Jun-wei;Zhang Wu-lin(Department of Thoracic and Cardiovascular Surgery, Third People's Hospital of Anyang, Anyang, Henan,455000, China)

机构地区：[1]河南省安阳市第三人民医院心胸外科,河南安阳455000

出　　处：《当代医学》2017年第21期14-16,共3页Contemporary Medicine

摘　　要：目的通过分析体外循环(on-pump)和非体外循环(off-pump)冠脉搭桥术围术期心型脂肪酸结合蛋白(heart-type fatty acidbinding protein,H-FABP)和肌钙蛋白I(cardiac troponin I,cTnI)变化,比较两种不同搭桥方法的心脏损伤程度。方法 50例行冠状动脉搭桥术患者被随机平均分为on-pump组和off-pump组,分别于术前、术后1,2,6,12 h和24 h检测H-FABP、cTnI并进行分析和比较。同时还记录术后机械通气时间、ICU停留时间、血管活性药物使用等临床指标。结果两组术后H-FABP和cTnI均高于术前(P<0.05);术后H-FABP达到峰值时间明显早于cTnI;on-pump组术后各时间点标本浓度高于off-pump组(P<0.05)。两组术后机械通气时间、ICU停留时间、血管活性药物使用均有显著性差异(P<0.05)。结论与cTnI相比,h FABP是更快速的围手术期心肌损伤标志物,非体外循环冠状动脉搭桥术心肌损伤较小。Objective To analyze the changes of perioperative release of heart-type fatty acid-binding protein(H-FABP)and cardiac troponin I(cTnI)to compare myocardial injury in on-pump versus off-pump coronary artery bypass grafting(CABG).Methods Fifty patients for CABG were randomly assigned to on-pump group or off-pump group,25in each group.The H-FABP and cTnI concentrations were measured in serial venous blood samples drawn before operation in both groups and at1,2,6,12and24hours after operation.In addition to biochemical measurements,datas were also recorded including the duration of mechanical ventilation postoperatively and ICU stay time,usage of vasoactive agent.Results The values of H-FABP and cTnI increased significantly in all samples after operation(P<0.05).The concentrations of H-FABP and cTnI perioperatively were higher in the on-pump than those in the off-pump group,and the difference has statistical significance(P<0.05).IMA and H-FABP levels peaked earlier than cTnI after operation.There was significant difference between two groups on the usage of vasoactive agent(P<0.05).The duration of mechanical ventilation postoperatively and ICU stay time were shorter in the on pump group,which had statistical significance(P<0.05).Conclusion H-FABP is a more rapid marker of perioperative myocardial damage,peaks earlier than cTnI.These datas demonstrate that off-pump CABG causes less myocardial damage than does off-pump CABG

关 键 词：心型脂肪酸结合蛋白 肌钙蛋白I 冠状动脉旁路移植术 体外循环 

分 类 号：R654.2[医药卫生—外科学]