瓣膜置换联合冠脉旁路移植术对冠心病并瓣膜疾病患者血清IL-17、IL-6及BNP水平的影响  

Effects of valve replacement combined with coronary artery bypass grafting on serum IL⁃17,IL⁃6 and BNP levels in patients with coronary artery disease and valvular disease

作　　者：刘怡雪 王海彦[1] 李少珂[1] LIU Yixue;WANG Haiyan;LI Shaoke(Department of Cardiac Surgery,Zhengzhou Seventh People's Hospital,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州市第七人民医院心外科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2024年第3期481-484,489,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(LHGJ20220843)。

摘　　要：目的 探讨瓣膜置换联合冠脉旁路移植术对冠心病并瓣膜疾病患者血清白细胞介素-17(IL-17)、白细胞介素-6(IL-6)及脑钠肽(BNP)水平的影响。方法 选取2021年2月至2022年1月郑州市第七人民医院收治的冠心病并瓣膜疾病患者78例,根据手术方式的不同分为对照组38例(予冠脉旁路移植术治疗)与试验组40例(予冠脉旁路移植术+瓣膜置换术治疗)。比较两组患者临床疗效、术后恢复情况、心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、心胸比]、炎性因子[IL-17、IL-6]、心衰因子[心钠肽(ANP)、BNP]及不良事件发生情况。结果 试验组临床总有效率(95.00%)比对照组临床总有效率(78.95%)高,差异有统计学意义(P<0.05)。两组住院时间、呼吸机应用时间、ICU监护时间相比较,差异无统计学意义(P>0.05)。术后3个月,试验组LVEDD、心胸比较对照组低,LVEF比对照组高,差异有统计学意义(P<0.05)。术后3个月,两组IL-6、IL-17水平均下降,且试验组比对照组低,差异有统计学意义(P<0.05)。术后3个月,两组ANP、BNP水平均下降,且试验组比对照组低,差异有统计学意义(P<0.05)。两组不良事件总发生率相比较,差异无统计学意义(P>0.05)。结论 对冠心病并瓣膜患者进行冠脉旁路移植术+瓣膜置换术治疗具有良好的临床疗效,可有效降低患者血清IL-6、IL-17、BNP水平,改善其心功能,具有一定安全性。Objective To investigate the effect of valve replacement combined with coronary ar-tery bypass grafting on serum interleukin-17(IL-17),interleukin-8(IL-6)and brain natriuretic peptide(BNP)levels in patients with coronary artery disease and valve disease.Methods A total of 78 patients with coronary heart disease and valvular disease were admitted to Zhengzhou Seventh People's Hospital from Febru-ary 2021 to January 2022.They were divided into two groups:38 cases in the control group(treated with coro-nary artery bypass grafting)and 40 cases in the experimental group(treated with coronary artery bypass graft-ing+valve replacement),based on the difference in surgical methods.The clinical efficacy,postoperative re-covery,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),cardiothoracic ratio],inflammatory factors[IL-17,IL-6],heart failure factors[atrial natriuretic peptide(ANP),BNP],and cardiofibrillation factors(CFF)were compared between the two groups.Results The total clinical effectiveness rate of the test group(95.00%)was higher than that of the control group(78.95%),and the difference was statistically significant(P<0.05).There were no significant differenc-es in hospitalization time,ventilator application time and ICU monitoring time between the two groups(P>0.05).Three months postoperatively,the test group had lower LVEDD and cardiothoracic ratio compared tothe control group,while LVEF was higher in the test group,with statistically significant differences(P<0.05).Addi-tionally,levels of IL-6 and IL-17 decreased in both groups after 3 months,with lower levels in the test group than the control group,showing statistical significance(P<0.05).Furthermore,ANP and BNP levels decreased in both groups at 3 months postoperatively,with lower levels in the test group compared to the control group,which was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse events be-tween the two groups(P>0.05).Conclusion Coronary

关 键 词：冠心病并瓣膜疾病 瓣膜置换术 冠脉旁路移植术 IL-17 IL-6 BNP 

分 类 号：R654.2[医药卫生—外科学]