体外循环心脏瓣膜置换术患者围手术期氧磷酶1与超氧化物歧化酶和丙二醛的变化及相关性  

Changes and correlation between PON1 and SOD and MDA in patients undergoing cardiac valve replacement during perioperative period of cardiopulmonary bypass

作　　者：黄初生 邓海龙 毕笑寒 赵文[1] 冼磊[1] HUANG Chu-sheng;DENG Hai-long;BI Xiao-han;ZHAO Wen;XIAN Lei(Department of Thoracic and Cardiovascular Surgery,The Second Affiliated Hospital of Guangxi Medical University,N anning 530007,Guangxi,China)

机构地区：[1]广西医科大学第二附属医院胸心血管外科,广西南宁530007

出　　处：《中国心血管病研究》2021年第11期982-985,共4页Chinese Journal of Cardiovascular Research

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20181002)。

摘　　要：目的研究体外循环(CPB)心脏瓣膜置换术患者围手术期对氧磷酶1(PON1)与超氧化物歧化酶(SOD)和丙二醛(MDA)的变化及相关性。方法随机数字法选取我院30例行CPB心脏瓣膜置换术的风湿性心脏瓣膜病患者,于心脏停搏前及恢复心脏血氧灌注后采集患者右心房组织,使用Real-time PCR检测PON1 mRNA的表达;分别于术前30 min、术后1 h和术后3 d采集患者外周静脉血,采用ELISA试剂盒检测血清PON1活性,黄嘌呤氧化酶法检测血清SOD水平,硫代巴比妥酸法检测血清MDA水平,并就血清PON1活性与SOD和MDA水平进行Pearson相关性分析。结果患者恢复心脏血氧灌注后心肌组织PON1 m RNA的表达为(0.61±0.16),显著低于心脏停搏前的(0.99±0.17)(P<0.05)。相较于术前,患者术后1 h的血清PON1和SOD水平均显著降低,MDA水平显著升高(P<0.05);术后3 d的血清PON1和SOD水平均显著升高,MDA水平显著降低(P<0.05);血清PON1水平与SOD水平呈显著正相关(r=0.666,P<0.05),PON1水平与MDA水平呈显著负相关(r=-0.583,P<0.05)。结论 PON1参与了CPB心脏瓣膜置换术缺血再灌注过程,血清PON1活性与SOD和MDA显著相关,PON1可能是反映心肌缺血再灌注中氧化应激损伤的潜在指标。Objective To investigate the changes and correlation between paroxysmase 1 and superoxide dismutase and malondialdehyde in patients undergoing cardiac valve replacement during perioperative period of cardiopulmonary bypass(CPB). Methods A total of 30 patients with rheumatic valvular heart disease who underwent cardiac Valve replacement with CPB in our hospital were selected by random number method. The right atrial tissue was collected before cardiac arrest and after restoration of cardiac blood and reoxygenation and the expression of PON1 m RNA was detected by Real-time PCR. Peripheral venous blood was collected 30 minutes before operation, 1 hour after operation and 3 days after operation. The activity of PON1 in serum was detected by ELISA;the serum SOD level was detected by xanthine oxidase method;the serum MDA level was detected by thiobarbituric acid method. Pearson correlation analysis was carried out between serum PON1 activity and serum SOD and MDA levels. Results The expression of PON1 mRNA level in myocardial tissue after restoring cardiac oxygen perfusion was(0.61 ± 0.16), significantly lower than that before cardiac arrest(P<0.05). Compared with which preoperation, serum levels of PON1 and SOD were significantly decreased at 1 h postoperation(P<0.05)and serum level of MDA was significantly increased at 1 h postoperation(P<0.05). After operation 3 days, the levels of serum PON1 and SOD were significantly increased and the level of MDA was significantly decreased.Serum PON1 level was positively correlated with SOD level(r=0.666,P<0.05) and serum PON1 level was negatively correlated with MDA level(r=-0.583,P<0.05). Conclusion PON1 is involved in the process of ischemia-reperfusion in cardiac valve replacement during CPB and may be a potential indicator of oxidative stress injury in myocardial ischemia-reperfusion.

关 键 词：心脏瓣膜置换术 缺血再灌注 氧磷酶 超氧化物歧化酶 丙二醛 

分 类 号：R654.2[医药卫生—外科学]