不同冠状动脉搭桥术式对血浆内皮素-1及左室收缩功能的影响

山东大学学报(医学版)

不同冠状动脉搭桥术式对血浆内皮素-1及左室收缩功能的影响

张孟元¹，徐艳冰¹,闫庆福²

1. 山东大学附属省立医院麻醉科，济南 250021； 2. 济宁医学院附属医院麻醉科，山东济宁 272001

收稿日期:2008-01-23 修回日期:1900-01-01 出版日期:2008-06-16 发布日期:2008-06-16
通讯作者: 徐艳冰

CABG with off-pump technique or cardiopulmonary bypass for serum Endothelin-1 and left ventricular function

ZHANG Meng-yuan¹, XU Yan-bing¹, YAN Qing-fu²

1. Department of Anesthesiology, Provincial Hospital Affiliated to Shandong University; 2. Department of Anesthesiology, Affiliated Hospital of Jining Medical College

Received:2008-01-23 Revised:1900-01-01 Online:2008-06-16 Published:2008-06-16
Contact: XU Yan-bing

摘要/Abstract

摘要： 目的探讨体外循环心脏停跳下冠状动脉搭桥术(CPB-CABG)与非体外循环心脏不停跳冠状动脉搭桥术(OPCABG)对血浆内皮素-1(ET-1)及左室收缩功能的影响。方法选择62例首次择期行冠状动脉搭桥术的冠心病患者,按是否应用心肺转流(CPB)随机均分为体外循环组(G1,n=30)和非体外循环组(G2,n=32)。分别在麻醉诱导前(T1)、切皮前(T2)以及术后6h(T3)、24h(T4)采集血标本,放免法测定ET-1含量。计算并分析心排血指数(CI)、左室做功指数(LVSWI)。结果与T1时点相比,G1组T3、T4时点ET1明显增加(P<0.05或P<0.01),G2组T2时点ET-1明显降低,T4时点明显升高(P<0.05)。与G1组相比,G2组T3、T4时点ET-1明显减低(P<0.05)。与T1时点相比,G1组T2、T3时点,G2组T2时点CI明显降低(P<0.05)。与T1时点相比,G1组T3、T4时点LVSWI明显降低(P<0.05)。与G1组相比,G2 组T3时点CI、LVSWI均显著性升高(P<0.05)。结论与体外循环心脏停跳下CABG相比,非体外循环心脏不停跳CABG可降低患者术后ET-1的产生，并且较少影响左室收缩功能。

关键词: 心肺转流, 冠状动脉搭桥术, 左心功能, 内皮素-1

Abstract: To explore the effects of coronary artery bypass graft(CABG) surgery performed by using both standard cardiopulmonary bypass (CPB) or the octopus technique on Endothelin-1(ET-1) levels and left ventricular function. MethodsSixty-two patients undergoing CABG surgeries were randomly divided into two groups: the G1 group (n=30) which received CPB-CABG and the G2 group(n=32) which received off-pump CABG (OPCABG). Blood samples were obtained before anesthesia (T1), before operation (T2), 6h(T3) and 24h(T4) after the end of operation. Serum Endothelin-1, CI and LVSWI were determined at each time-point. ResultsSerum ET-1 of the G1 group was significantly increased at T3 and T4 time-points and of the G2 group was decreased at T2 timepoint and increased at T4 timepoint. Serum ET-1 of the G2 group was decreased at T3 and T4 time-points compared with the G1 group (P<0.05). Compared with T1 time-point, CI of the G1 group at T2 and T3 time-points and that of the G2 group at T2 time-point were markedly decreased (P<0.05), and also LVSWI of the G1 group at the T3 and T4 timepoints were markedly decreased (P<0.05). Compared with the G1 group, CI and LVSWI of the G2 group at the T3 time-point were increased (P<0.05). Conclusion Off-pump CABG can decrease the output of ET-1 and has a protective effect on myocardial injury and it is superior to CPB-CABG.

Key words: Endothelin-1, Left heart function, Cardiopulmanory bypass, Coronary artery bypass grafting

中图分类号:

R654.2

张孟元,徐艳冰,闫庆福 . 不同冠状动脉搭桥术式对血浆内皮素-1及左室收缩功能的影响[J]. 山东大学学报(医学版), 2008, 46(6): 594-596.

ZHANG Meng-yuan,XU Yan-bing,YAN Qing-fu. CABG with off-pump technique or cardiopulmonary bypass for serum Endothelin-1 and left ventricular function[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(6): 594-596.

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