非体外循环下冠状动脉旁路移植术后患者氧自由基、心肌损伤因子及炎性因子的变化  

Changes in Oxygen Free Radicals,Myocardial Damage-related Factors and Inflammatory Factors in Patients after Off-pump Coronary Artery Bypass Transplantation

作　　者：吴光航 吕晶 王俊华[1] 李华军 WU Guanghang;LYU Jing;WANG Junhua;LI Huajun(Department of Cardiac Surgery,Hanzhong Central Hospital,Hanzhong,Shaanxi 723000,China)

机构地区：[1]汉中市中心医院心脏外科,陕西汉中723000

出　　处：《临床误诊误治》2023年第7期86-90,共5页Clinical Misdiagnosis & Mistherapy

基　　金：陕西省重点研发计划项目(2020SF-11321)。

摘　　要：目的 探究非体外循环下冠状动脉旁路移植术(OPCABG)后患者氧自由基、心肌损伤因子及炎性因子的变化。方法 选择2019年10月—2022年10月收治的93例冠心病,根据手术方案分为非体外组51例(予OPCABG)与体外组42例(予体外循环冠状动脉旁路移植术),对比2组手术相关指标,治疗前和治疗后2、6、24 h血清氧自由基、心肌损伤因子及炎性因子水平。结果 非体外组手术时间、入住重症监护病房时间、气管插管时间、住院时间均短于体外组,术后24 h输血量少于体外组(P<0.01)。治疗后2组超氧化物歧化酶(SOD)水平先降后升,丙二醛(MDA)水平先升后降,且非体外组SOD、MDA水平变化幅度明显小于体外组(P<0.05,P<0.01)。随着治疗时间延长,2组心肌型肌酸激酶同工酶(CK-MB)水平逐渐升高,且非体外组术后2、6、24 h CK-MB水平均低于体外组(P<0.05,P<0.01);2组治疗后,心肌肌钙蛋白I(cTnI)水平先升后降,且非体外组术后2、6、24 h cTnI水平均低于体外组(P<0.05,P<0.01)。随着治疗时间的延长,2组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)水平逐渐下降,且非体外组术后2、6、24 h IL-6、IL-8、IL-10水平均低于体外组(P<0.05,P<0.01)。结论 OPCABG可有效降低冠心病患者氧自由基、炎性因子水平,并可减轻心肌损伤,较体外循环冠状动脉旁路移植术疗效好。Objective To investigate the changes of oxygen free radicals,myocardial damage-related factors and inflammatory factors in patients after off-pump coronary artery bypass grafting(OPCABG).Methods In total,93 patients with coronary heart disease(CHD) treated from October 2019 to October 2022 were selected and divided into the OPCABG group(receiving OPCABG,n=51) and the on-pump coronary artery bypass grafting(CABG) group(receiving CABG,n=42) according to the surgical plan.The surgery-related factors,and the levels of serum oxygen free radicals,myocardial damage-related factors and inflammatory factors before and at 2,6 and 24 h after treatment were compared between the two groups.Results The duration of operation,length of ICU stay,duration of tracheal intubation,and length of hospitalization in the OPCABG group were shorter than those in the on-pump CABG group,and the blood transfusion volume at 24 h after operation was less than that in the on-pump CABG group(P<0.01).After treatment,the level of superoxide dismutase(SOD) decreased first and then increased,and the level of malondialdehyde(MDA) increased first and then decreased;the changes of SOD and MDA levels in OPCABG group were significantly smaller than those on-pump CABG group(P<0.05,P<0.01).With the extension of treatment time,the level of myocardial creatine kinase isoenzyme(CK-MB) in the two groups was gradually increased,and the level of CK-MB in OPCABG group was lower than that on-pump CABG group at 2,6 and 24 h after surgery(P<0.05,P<0.01).After treatment,the level of cardiac troponin I(cTnI) in the two groups increased initially and then decreased,and the cTnI level in the OPCABG group was lower than that on-pump CABG group at 2,6 and 24 h after surgery(P<0.05,P<0.01).With the prolongation of treatment,the levels of interleukin-6(IL-6),interleukin-8(IL-8) and interleukin-10(IL-10) in the two groups were gradually decreased,which were lower in OPCABG group than in on-pump CABG group at 2,6 and 24 h after surgery(P<0.05,P<0.01).Conclusion OPCABG can effe

关 键 词：冠心病 冠状动脉旁路移植术 非体外循环 超氧化物歧化酶 丙二醛 心肌型肌酸激酶同工酶 肌钙蛋白I 白细胞介素-6 白细胞介素-8 

分 类 号：R541.4[医药卫生—心血管疾病]