体外循环旁路洗入七氟醚对冠状动脉旁路移植术患者心肌炎性反应的影响.pdf

《体外循环旁路洗入七氟醚对冠状动脉旁路移植术患者心肌炎性反应的影响.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、中华麻醉学杂志2013年lO月第33卷第10期ChinJAnesthesiol，October2013，．塑，l101185麻醉并发症·体外循环旁路洗入七氟醚对冠状动脉旁路移植术患者心肌炎性反应的影响王永旺喻文立薛玉良翁亦齐石屹崴王刚李津源杜洪印【摘要】目的评价CPB旁路洗人七氟醚对冠状动脉旁路移植术(CABG)患者心肌炎性反应的影响。方法择期CPB下行CABG的患者40例，年龄45～60岁，体重53～89kg，ASA分级Ⅱ或Ⅲ级，采用随机数字表法，将其分为2组(n=20)：对照组(c组)和七氟醚组(s组)。s组于CPB期间通过体外循

2、环机洗入1．O％～2．0％七氟醚。于麻醉诱导后5min、CPB结束后4、12和24h时，采集中心静脉血样，测定血浆心肌肌钙蛋白I(cTnI)浓度。于CPB结束时取右心耳组织，采用免疫组化法测定IL-6和IL-1p的表达。结果与C组比较，s组血浆crrnI浓度降低，心肌组织IL广1p和IL-6表达下调(P<0．05)。结论CPB旁路洗人七氟醚减轻CABG患者心肌损伤的机制与其抑制炎性反应有关。【关键词】麻醉药，吸人；心肺转流术；炎症；心肌；冠状动脉分流术Efectsofsevofluranewash-induringcardiopulm

3、onarybypassoninflammatoryresponsesinpatientsunder-goingcoronaryarterybypassgraftingWANGYong-wang，YUWen—li，XUEYu—liang，WENGYi-qi，SHIYi-wei，WANGG口，，Jia—yuaa，DUHong-yin．DepartmentofAnesthesiology，TianjinFirstCentralHospital，300192Tianfin，ChinaCorrespondingauthor：DUHong-yin

4、。Email：duhongyin@hotmail．corn．cn【Abstract】ObjectiveToinvestigatetheeffectsofsevofluranewash—induringcardiopulmonarybypass(CPB)oninflammatoryresponsesinpatientsundergoingcoronaryarterybypassgrafting(CABG)．MethodsFortyASAphysicalstatusⅡorIllpatients，aged45'60yr，weighing53

5、—89kg，scheduledforelectiveCABGunderCPB，wererandomlydividedinto2groups(n=20each)usingarandomnumbertable：controlgroup(groupC)andsevofluranegroup(groupS)．Sevoflurane1％一2％waswashedintotheextracorporealcircuitduringCPBingroupS．Bloodsamplesweretakenfromthecentralveinat5rainaf

6、terinductionofanesthesiaand4，12and24hafterterminationofCPBfordeterminationoftheconcentrationofplasmacardiactroponinI(cTnI)．MyocardialspecimenswereobtainedfromtherightauricleattheendofCPBfordeterminationofIL-i~andIL一6expressionbyimmuno—histochemistry．ResultsComparedwithg

7、roupC，theplasmaconcentrationofcTn1wassignificantlyde—creased，andIL-l8andIL-6expressioninmyocardialtissueswasdown—regulatedingroupS(P<0．05)．Conclu-sionThemechanismbywhichsevofluranewash—induringCPBattenuatesmyocardialinjuryisrelatedtoinhibitionofinflammatoryresponsesinpa

8、tientsundergoingCABG．【Keywords】Anesthetics，inhalation；Cardiopulmonarybypass；Inflammation；Myocardial；Coro—narya