重组人脑利钠肽对非体外循环冠状动脉搭桥患者术后BNP、cTnI、LVEF的影响  

Effects of recombinant human natriuretic peptide on the postoperative BNP,cTnI and LVEF of off-pump coronary artery bypass patients

作　　者：宋书田[1] 王玉通[1] 周岊梧[1] 白传明[1] 杨明[1] SONG Shu-tian;WANG Yu-tong;ZHOU Ji-wu;BAI Chuan-ming;YANG Ming(Department of Cardiothoracic Surgery,Cangzhou Central Hospital,Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北省沧州市中心医院心胸外科,河北沧州061000

出　　处：《河北医科大学学报》2018年第2期150-154,共5页Journal of Hebei Medical University

摘　　要：目的观察重组人脑利钠肽(recombinant human brain natriuretic peptide,rhBNP)对非体外循环冠状动脉搭桥(off-pump coronary artery bypass grafting,OPCABG)患者人脑利钠肽(brain natriuretic peptide,BNP)、肌钙蛋白I(cardiac troponin I,cTnI)、左心室射血分数(left ventricular ejection fraction,LVEF)的影响。方法将接受OPCABG术的103例患者按随机数字表法分为rhBNP组52例和对照组51例。分别于术前、术后即刻(用药前)、术后24h、术后48h、术后7d抽取静脉血,检测BNP以及cTnI;分别于术前、术后即刻(用药前)、术后24h、术后48h、术后7d行心脏彩色多普勒超声心动图检查LVEF。结果 2组桥血管情况差异无统计学意义(P>0.05)。2组cTnI和BNP均呈先升高再降低的趋势,cTnI于术后24h达峰值,BNP于术后48h达峰值,rhBNP组变化幅度小于对照组,2组LVEF均呈先降低后升高的趋势,术后48h达最低值,rhBNP组高于对照组,其组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05)。2组住院期间心血管事件发生情况差异无统计学意义(P>0.05)。结论 OPCABG术后应用rhBNP可减少内源性BNP、cTnI的释放;应用rhBNP可改善术后心脏功能状态。Objective To observe the effects of the recombinant human brain natriuretic peptide(rhBNP)on the postoperative brain natriuretic peptide(BNP),cardiac troponin I(cTnI)and left ventricular ejection fraction(LVEF)of the off-pump coronary artery bypass grafting(OPCABG).Methods The 103 cases of OPCABG in our hospital were randomly divided into the rhBNP and the control group,including 52 of the rhBNP group and 51 in the control group.Before operation,immediately after operation(before medicinal),24 h after operation,48 h after operation,and 7 days after operation,the blood was extracted to detect the BNP and the cTnI and cardiac color doppler uhrasonography was examined to check up LVEF.Results The difference between the two groups patients of saphenous bypass graft was statistically significant(P>0.05).cTnI and the BNP of the two groups were increased first and then decreased,and the peak value of cTnI was at 24 h after the operation.The peak value of BNP was at 48 h after operation,and the variation of rhBNP group was less than that of the control group.The LVEF of 2 groups showed a trend of decreasing first and then increasing.The lowest value was at 48 h after operation,and the rhBNP group was higher than that of the control group.There was significant difference in interaction between group,time point and group point(P<0.05).There was no statistically significant difference in cardiovascular events between the two groups(P>0.05).Conclusion The OPCABG postoperative application of rhBNP can reduce the release of endogenous BNP and cTnI.RhBNP can be used to improve postoperative cardiac function.

关 键 词：利钠肽 脑 冠状动脉旁路移植术 肌钙蛋白 

分 类 号：R654.3[医药卫生—外科学]