小剂量甘露醇缓慢静脉滴注对心肺转流术心脏术后cTnT、CRP、TNF-α、IL-6的影响  

The Effect of Slow Intravenous Infusion of Low-Dose Mannitol on cTnT,CRP,TNF-α,and IL-6 Levels after Cardiopulmonary Bypass Surgery

作　　者：张辉 田艳丽 师启众[2] 郭浩[2] Zhang Hui;Tian Yanli;Shi Qizhong;Guo Hao(North Sichuan College of Preschool Teacher Education,Guangyuan,Sichuan 628017,China;The Third Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453000,China)

机构地区：[1]川北幼儿师范高等专科学校,四川广元628017 [2]新乡医学院第三附属医院,河南新乡453000

出　　处：《大理大学学报》2025年第2期46-50,共5页Journal of Dali University

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190488)。

摘　　要：目的:探讨小剂量甘露醇缓慢静脉滴注对心肺转流术(CPB)心脏术后心肌肌钙蛋白T(cTnT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平的影响,以评估该治疗策略对减轻术后不良反应的有效性。方法:将2020年6月至2022年3月新乡医学院第三附属医院就诊的71例接受CPB心脏手术患者纳入研究。患者随机分为对照组和试验组,对照组采用常规治疗,试验组在常规治疗基础上采用小剂量甘露醇静脉滴注治疗。比较2组患者术后不同时间点cTnT、CRP、TNF-α、IL-6水平。结果:2组患者cTnT、CRP、TNF-α和IL-6在术后均呈现先升高后降低的趋势,达到峰值的时间分别为术后36 h、术后2 d、术后6 h和术后12 h,组间比较、时间效应和变化趋势差异均有统计学意义(P<0.05);试验组各指标的峰值水平更低,且下降速度更快。结论:小剂量甘露醇缓慢静脉滴注能有效降低CPB心脏术后cTnT、CRP、TNF-α、IL-6水平,减轻术后不良反应,具有临床推广价值。Objective:To investigate the effects of slow intravenous infusion of low-dose mannitol on cardiac troponin T(cTnT),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)levels after cardiopulmonary bypass(CPB)cardiac surgery,and to evaluate the efficacy of this therapeutic strategy in mitigating postoperative adverse reactions.Methods:A total of 71 patients who underwent CPB cardiac surgery at the Third Affiliated Hospital of Xinxiang Medical University from June 2020 to March 2022 were included in the study.Patients were randomly divided into a control group and an experimental group.The control group received conventional treatment,while the experimental group received additional low-dose mannitol infusion therapy based on conventional treatment.The levels of cTnT,CRP,TNF-α,and IL-6 were compared at different time points postoperatively between the two groups.Results:The levels of cTnT,CRP,TNF-α,and IL-6 increased initially and then decreased in both groups postoperatively,with peak levels observed at 36 hours,2 days,6 hours,and 12 hours postoperatively,respectively.There were statistically significant differences in intergroup comparisons,time effects,and trends of change(P<0.05).The peak levels of these indicators were lower,and the decrease rate was faster in the experimental group.Conclusion:Slow intravenous infusion of low-dose mannitol can effectively reduce the levels of cTnT,CRP,TNF-α,and IL-6 after CPB cardiac surgery,alleviate postoperative adverse reactions,and holds clinical promotional value.

关 键 词：心肺转流术 心脏手术 小剂量甘露醇 心脏保护 炎症标志物 心肌损伤 

分 类 号：R654.1[医药卫生—外科学]