【摘要】：目的通過多指標(biāo)評估對比體外循環(huán)冠狀動脈旁路移植術(shù)(CABG)與非體外循環(huán)冠狀動脈旁路移植術(shù)(OPCABG)心肌損傷程度。方法 2010年1月至2014年1月在該院接受冠狀動脈旁路移植手術(shù),選取CABG和OPCABG患者各30例作為研究對象。根據(jù)手術(shù)方式將行CABG記為對照組,行OPCABG記為觀察組。對比兩組手術(shù)麻醉誘導(dǎo)5min后(T0)、術(shù)后1d(T1)及2d(T2)的心肌肌鈣蛋白I(cTnI)濃度、肌酸激酶-同工酶(CK-MB)活性、氨基酸末端前體腦鈉肽(NT-proBNP)濃度及IL-6水平。并計算心肌細胞線粒體損傷,統(tǒng)計對比術(shù)后24h的收縮壓(SBP)、舒張壓(DBP)及平均動脈壓(MAP)。結(jié)果兩組患者T0時刻的cTnI、CK-MB、NT-proBNP及任何時刻的IL-6水平比較差異無統(tǒng)計學(xué)意義(P0.05),觀察組在T1、T2時刻的cTnI、CK-MB、NT-proBNP均低于對照組(P0.05)。觀察組在術(shù)后心肌細胞線粒體損傷評分為(1.90±0.27)分,顯著低于對照組的(2.80±0.31)分,觀察組SBP、DBP及MAP等血壓指標(biāo)均高于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論 OPCABG術(shù)后對心肌損傷程度小于CABG,并且OPCABG術(shù)后患者恢復(fù)更快,臨床上利用價值更高。
[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 鹵0.27), significantly lower than that in the control group (2.80 鹵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.
【作者單位】： 北京大學(xué)深圳醫(yī)院心血管外科;
【分類號】：R654.2

【參考文獻】

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