探究血浆肝素结合蛋白与体外循环心外科术后并发症的关系  

Relationship between plasma heparin-binding protein and postoperative complications in extracorporeal circulation cardiac surgery

作　　者：陈冰莹 林风辉[2] 周晓芬[1] 黄廷烽 江信达 陈明光[2] 严骏 Chen Bingying;Lin Fenghui;Zhou Xiaofen;Huang Tingfeng;Jiang Xinda;Chen Mingguang;Yan Jun(Shengli Clinical Medical College of Fujian Medical University,Fuzhou 350001,China;The Fourth Department of Intensive Care Unit,Fujian Provincial Hospital,Fuzhou 350001,China;Cardiovascular Surgery Department,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福州350001 [2]福建省立医院重症医学四科,福州350001 [3]福建省立医院心血管外科,福州350001

出　　处：《创伤与急诊电子杂志》2023年第2期67-72,共6页Journal of Trauma and Emergency(Electronic Version)

基　　金：福建省自然科学基金(2023J011179)。

摘　　要：目的探讨血浆肝素结合蛋白与体外循环心外科术后并发症之间的关系。方法收集2022年4月至2022年12月在福建省立医院心外科接受体外循环下的心脏手术的158例患者的临床资料,进行回顾性分析。根据是否出现并发症,将患者分为并发症组(76例)和无并发症组(82例),比较两组患者的术前一般资料、术中相关指标、术后的临床资料。结果与无并发症组比较,并发症组患者的高血压患病情况(35.5%比11%,Walsχ^(2)=12.300,P<0.001)、体重指数[(23.85±3.59)kg/m2比(22.57±2.93)kg/m2,Walsχ^(2)=5.676,P=0.017]、术中主动脉阻断时间[116.50(91.00,142.75)min比105.00(76.00,132.00)min,Walsχ^(2)=6.803,P=0.009]、术后血浆肝素结合蛋白[128.56(70.82,183.15)ng/ml比92.34(54.01,136.44)ng/ml,Wals χ^(2)=9.203,P=0.002]明显增高。多因素Logistics回归结果提示高血压(OR=4.080,95%CI:1.576~10.563,P=0.004)、主动脉阻断时间(OR=1.012,95%CI:1.002~1.021,P=0.015)、术后血浆肝素结合蛋白水平(OR=1.011,95%CI:1.004~1.017,P=0.002)是体外循环术后发生并发症的危险因素。结论血浆肝素结合蛋白升高是心外科体外循环术后发生并发症的危险因素。Objective To investigate the relationship between plasma heparin-binding protein and postoperative complications in patients undergoing cardiac surgery with extracorporeal circulation.Method Clinical data of 158 patients who underwent cardiac surgery with extracorporeal circulation in the Department of Cardiovascular Surgery at Fujian Provincial Hospital from April 2022 to December 2022 were collected and retrospectively analyzed.Preoperative general information,intraoperative relevant indicators,and postoperative clinical data were collected.Based on the presence of complications,patients were divided into a complication group(76 cases)and a non-complication group(82 cases)for statistical analysis Result The complication group showed a higher incidence of hypertension(35.5%vs 11%,Walsχ^(2)=12.300,P<0.001),higher body mass index[(23.85±3.59)kg/m2 vs(22.57±2.93)kg/m2,Walsχ^(2)=5.676,P=0.015],longer aortic cross-clamp time[116.50(91.00,142.75)min vs 105.00(76.00,132.00)min,Walsχ^(2)=6.803,P=0.014],and higher postoperative plasma heparin-binding protein[128.56(70.82,183.15)ng/ml vs 92.34(54.01,136.44)ng/ml,Walsχ^(2)=9.203,P=0.002]than the non-complication group(all P<0.05).Multivariate logistic regression analysis indicated that hypertension(OR=4.080,95%CI:1.576~10.563,P=0.004),aortic cross-clamp time(OR=1.012,95%CI:1.002~1.021,P=0.015),and postoperative plasma heparin-binding protein level(OR=1.011,95%CI:1.004~1.017,P=0.002)were risk factors for postoperative complications of extracorporeal circulation surgery.Conclusion The level of heparin-binding protein in plasma is a risk factor for postoperative complications of cardiac surgery with extracorporeal circulation.

关 键 词：体外循环 高血压 主动脉阻断时间 肝素结合蛋白 并发症 

分 类 号：R654.2[医药卫生—外科学]