多指标评估体外循环与非体外循环冠状动脉旁路移植术心肌损伤的研究
发布时间：2019-04-21 10:09
【摘要】：目的通过多指标评估对比体外循环冠状动脉旁路移植术(CABG)与非体外循环冠状动脉旁路移植术(OPCABG)心肌损伤程度。方法 2010年1月至2014年1月在该院接受冠状动脉旁路移植手术,选取CABG和OPCABG患者各30例作为研究对象。根据手术方式将行CABG记为对照组,行OPCABG记为观察组。对比两组手术麻醉诱导5min后(T0)、术后1d(T1)及2d(T2)的心肌肌钙蛋白I(cTnI)浓度、肌酸激酶-同工酶(CK-MB)活性、氨基酸末端前体脑钠肽(NT-proBNP)浓度及IL-6水平。并计算心肌细胞线粒体损伤,统计对比术后24h的收缩压(SBP)、舒张压(DBP)及平均动脉压(MAP)。结果两组患者T0时刻的cTnI、CK-MB、NT-proBNP及任何时刻的IL-6水平比较差异无统计学意义(P0.05),观察组在T1、T2时刻的cTnI、CK-MB、NT-proBNP均低于对照组(P0.05)。观察组在术后心肌细胞线粒体损伤评分为(1.90±0.27)分,显著低于对照组的(2.80±0.31)分,观察组SBP、DBP及MAP等血压指标均高于对照组,差异均有统计学意义(P0.05)。结论 OPCABG术后对心肌损伤程度小于CABG,并且OPCABG术后患者恢复更快,临床上利用价值更高。
[Abstract]:Objective to evaluate the degree of myocardial injury in patients with coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCABG). Methods from January 2010 to January 2014, 30 patients with CABG and 30 patients with OPCABG were selected for coronary artery bypass grafting (CABG). According to the operation mode, CABG was recorded as the control group and OPCABG as the observation group. Cardiac troponin I (cTnI) concentration, creatine kinase isoenzyme (CK-MB) activity and cardiac troponin I (cTnI) concentration were compared between the two groups after induction of 5min (T 0), day 1 (T 1) and day 2 (T 2) after operation. Amino acid terminal probrain natriuretic peptide (NT-proBNP) concentration and IL-6 level. The mitochondrial damage of myocardial cells was calculated. Systolic blood pressure (SBP),) diastolic blood pressure (DBP) and mean arterial pressure (MAP).) 24 hours after operation were compared statistically. Results there was no significant difference in the levels of cTnI,CK-MB,NT-proBNP at T0 and IL-6 at any time between the two groups (P0.05). The cTnI,CK-MB,NT-proBNP in observation group was lower than that in control group at T1 and T2 (P0.05). The score of myocardial mitochondrial injury in the observation group was (1.90 卤0.27), significantly lower than that in the control group (2.80 卤0.31). The blood pressure indexes such as SBP,DBP and MAP in the observation group were higher than those in the control group. The difference was statistically significant (P0.05). Conclusion the degree of myocardial injury after OPCABG is less than that of CABG, and the recovery of patients after OPCABG is faster and the clinical value is higher.
【作者单位】： 北京大学深圳医院心血管外科;
【分类号】：R654.2
[Abstract]:Objective to evaluate the degree of myocardial injury in patients with coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCABG). Methods from January 2010 to January 2014, 30 patients with CABG and 30 patients with OPCABG were selected for coronary artery bypass grafting (CABG). According to the operation mode, CABG was recorded as the control group and OPCABG as the observation group. Cardiac troponin I (cTnI) concentration, creatine kinase isoenzyme (CK-MB) activity and cardiac troponin I (cTnI) concentration were compared between the two groups after induction of 5min (T 0), day 1 (T 1) and day 2 (T 2) after operation. Amino acid terminal probrain natriuretic peptide (NT-proBNP) concentration and IL-6 level. The mitochondrial damage of myocardial cells was calculated. Systolic blood pressure (SBP),) diastolic blood pressure (DBP) and mean arterial pressure (MAP).) 24 hours after operation were compared statistically. Results there was no significant difference in the levels of cTnI,CK-MB,NT-proBNP at T0 and IL-6 at any time between the two groups (P0.05). The cTnI,CK-MB,NT-proBNP in observation group was lower than that in control group at T1 and T2 (P0.05). The score of myocardial mitochondrial injury in the observation group was (1.90 卤0.27), significantly lower than that in the control group (2.80 卤0.31). The blood pressure indexes such as SBP,DBP and MAP in the observation group were higher than those in the control group. The difference was statistically significant (P0.05). Conclusion the degree of myocardial injury after OPCABG is less than that of CABG, and the recovery of patients after OPCABG is faster and the clinical value is higher.
【作者单位】： 北京大学深圳医院心血管外科;
【分类号】：R654.2
【参考文献】
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