同期行心脏瓣膜术与冠状动脉旁路移植术治疗心脏瓣膜病患者对其心肌损伤及炎症因子水平的影响  

Effects of Simultaneous Heart Valve Surgery and Coronary Artery Bypass Grafting on Myocardial Injury and Inflammatory Factor Levels in Patients with Heart Valve Disease Treatment

作　　者：王柱 谢亚轩 李庆 WANG Zhu;XIE Yaxuan;LI Qing(Department of Cardiothoracic Surgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州医科大学附属医院心胸外科,江苏徐州221000

出　　处：《中外医疗》2023年第26期13-16,106,共5页China & Foreign Medical Treatment

摘　　要：目的探究同期行心脏瓣膜术与冠状动脉旁路移植术治疗心脏瓣膜病患者对其心肌损伤及炎症因子水平的影响。方法随机选取2019年3月—2022年7月徐州医科大学附属医院收治的90例心脏瓣膜病患者为研究对象,依据随机数表法分为非同期组与同期组,每组45例,非同期组采用心脏瓣膜术与冠状动脉旁路移植术不同期手术治疗,同期组采用心脏瓣膜术联合冠状动脉旁路移植术同期手术治疗。对比两组患者术后恢复情况、治疗前后心肌损伤指标、炎症因子水平以及心功能指标。结果术后,同期组的呼吸机使用时间(65.62±10.77)h、重症加强护理病房(intensive care unit,ICU)时间(6.85±1.47)d、住院时间(15.86±3.64)d均短于非同期组,差异有统计学意义(t=12.222、19.418、9.825,P<0.05)。同期组心肌肌钙蛋白I、N末端脑钠肽前体、血清肌酸激酶同功酶水平均低于非同期组,差异有统计学意义(P<0.05)。同期组白介素-6、超敏C反应蛋白、肿瘤坏死因子-α水平均低于非同期组,差异有统计学意义(P<0.05)。同期组的左心室射血分数高于非同期组,心胸比、左心室舒张末期内径低于非同期组,差异有统计学意义(P<0.05)。结论心脏瓣膜病患者实施同期行心脏瓣膜术与冠状动脉旁路移植术治疗,可以缩短呼吸机使用时间、住院时间等,改善其心肌受损情况,降低其体内的炎症因子水平,稳定患者心功能,对患者病情恢复有积极影响。Objective To investigate the effects of simultaneous heart valve surgery and coronary artery bypass grafting for heart valve disease patients on their myocardial injury and inflammatory factor levels.Methods 90 patients with heart valve disease admitted to the Affiliated Hospital of Xuzhou Medical University from March 2019 to July 2022 were randomly selected as the study objects and divided into two groups(non-simultaneous and simultaneous groups)based on the randomized numerical table method,with 45 cases in each group.The non-simultaneous group was treated with non-simultaneous heart valve surgery and coronary artery bypass grafting,and the simultaneous group was treated with simultaneous heart valve surgery and coronary artery bypass grafting.Postoperative recovery,myocardial injury indexes,inflammatory factor levels and cardiac function indexes before and after treatment were compared between the two groups.Results After surgery,the ventilator use time(65.62±10.77)h,intensive care unit(ICU)time(6.85±1.47)d,and hospitalization time(15.86±3.64)d of the simultaneous group were shorter than those of the non-simultaneous group,and the differences were statistically significant(t=12.222,19.418,9.825,P<0.05).Cardiac troponin I,N-terminal brain natriuretic peptide precursor,and serum creatine kinase isoenzyme levels were lower in the simultaneous group than in the non-simultaneous group,the differences were statistically significant(P<0.05).The levels of interleukin-6,ultrasensitive C-reactive protein,and tumor necrosis factor-a in the simultaneous group were lower than in the non-simultaneous group,and the differences were statistically significant(P<0.05).The left ventricular ejection fraction of the simultaneous group was higher than that of the non-simultaneous group,and the cardiothoracic ratio and left ventricular end-diastolic internal diameter were lower than those of the nonsimultaneous group,and the differences were statistically significant(P<0.05).Conclusion The implementation of simultaneous heart va

关 键 词：同期 心脏瓣膜术 冠状动脉旁路移植术 心脏瓣膜病 心肌损伤 炎症因子 心功能 

分 类 号：R542[医药卫生—心血管疾病]