TM水平在冠心病患者冠状动脉旁路移植术围术期改变及与动脉硬化指数的关系  

The relationship between TM level in the perioperative period of coronary artery bypass grafting and arteriosclerosis index in patients with coronary heart disease

作　　者：马杰[1] 马千里[1] 廖红娟[1] 张焱 安景辉[1] MA Jie;MA Qianli;LIAO Hongjuan;ZHANG Yan;AN Jing Hui(Department of Cardiac Surgery,The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei,China,050000)

机构地区：[1]河北医科大学第二医院心脏外科,河北石家庄050000

出　　处：《分子诊断与治疗杂志》2022年第2期295-298,303,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫生健康委医学科学研究课题计划(20160548)。

摘　　要：目的探讨血栓调节蛋白(TM)水平在冠心病(CHD)患者冠状动脉旁路移植术(CAGB)围手术期改变及与动脉硬化指数的关系。方法选取2021年1月至2021年9月河北医科大学第二医院心外科收治的150例行CABG的冠心病患者为研究对象,依据其入院后动脉硬化指数(AI)分为正常组118例(AI值<4)和增高组32例(AI值≥4)。比较两组TM水平变化,比较不同冠状动脉旁路移植术TM水平变化,分析TM与AI之间的关系。结果两组TM水平在术前、麻醉后即刻、术后6、12、24 h AI增高组TM水平显著高于AI正常组,差异有统计学意义(P<0.05);术后7 d,两组水平均上升但OPCABG组TM水平显著低于CCABG组,差异有统计学意义(P<0.05);Spearman相关分析表明,围术期患者TM与AI呈正相关(r=0.551,P<0.001);多因素Logistic回归分析显示,TC水平升高、HDL水平过低、有高血压、TM水平升高、LVEF<35%等为AI值增高的独立危险因素(P<0.05)。结论TM水平在行CAGB围手术期的CHD患者中有增高趋势,为AI值增高的危险因素。Objective To investigate the perioperative changes of TM level in patients with coronary artery disease(CHD)after coronary artery bypass grafting(CAGB)and its relationship with arteriosclerosis index.Methods From January 2021 to September 2021,150 patients with coronary heart disease underwent CABG who were admitted to the Department of Cardiac Surgery of the Second Hospital of Hebei Medical University were selected as the research objects.According to their arteriosclerosis index(AI)after admission,they were divided into the normal group of 118 patients(AI value<4)and 32 cases in the increased group(AI value≥4).The changes of TM levels in the two groups were compared,and the changes of TM levels in different coronary artery bypass grafting were compared,and the relationship between TM and AI was analyzed.Results The levels of TM in the two groups before surgery,immediately after anesthesia,and at 6,12,and 24 h after surgery in the AI-increased group were significantly higher than those in the AInormal group,and the differences were statistically significant(P<0.05).On the 7 th day after operation,the levels of both groups increased,but the level of TM in the OPCABG group was significantly lower than that in the CCABG group,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that TM was positively correlated with AI in perioperative patients(r=0.551,P<0.001).Multivariate logistic regression analysis showed that elevated TC levels,low HDL levels,hypertension,elevated TM levels,and LVEF<35%were independent risk factors for increased AI values(P<0.05).Conclusion TM levels tend to increase in CHD patients undergoing CAGB perioperative period,which is a risk factor for increased AI value.

关 键 词：血栓调节蛋白 冠心病 冠状动脉旁路移植术 动脉硬化指数 

分 类 号：R541.4[医药卫生—心血管疾病]