冠状动脉搭桥术-体外循环患者炎性指标和心肌损伤标志物的检测分析

Analysis of Inflammatory Factors and Myocardial Damage Markers by Testing the Patients Undergone CABG Surgery by CPB

目的:检测分析冠状动脉搭桥术(CABG)-体外循环(CPB)冠心病(CHD)患者的炎性和心肌损伤监测指标。方法:分别在CPB前、中、后即刻、后2h、6h、12h、24h、48h,测定炎性指标白介素-6(IL-6)、白介素-8(IL-8)、白细胞数量(WBC)及心肌损伤标志物肌红蛋白(MYO)、肌钙蛋白I(cTnI)、肌酸激酶同工酶MB质量(CK-MBmass),并对WBC和cTnI变化进行趋势分析。结果:IL-6和IL-8在CPB后逐渐上升;WBC和cTnI在CPB后开始逐渐上升,CPB后24h达到高峰,然后下降;WBC和cTnI与其它指标呈明显正相关(P<0.01);MYO在CPB后即刻和CPB后24h出现双峰。结论:行CABG-CPB患者炎症和心肌损伤指标的监测有重要临床意义。

Objective: To analyze and optimize the monitoring items of inflammatory reaction and myocardial damage for the patients with coronary heart disease (CHD), who will be undergone coronary artery by pass graft (CABG) surgery by cardiopulmonary bypass (CPB). Method: Interleukin-6 (IL-6), interleukin-8 (IL-8), white blood cell (WBC), myoglobulin (MYO), troponin I (cTnI), creatine kinase MB mass (CK-MB mass) were tested in different time spots which in order are before CPB, on CPB, after CPB at that time, after CPB 2 hour, after CPB 6 hour, after CPB 12 hour, after CPB 24 hour, after CPB 48 hour. Then analyze the changing tendencies of the preferential monitoring items WBC and cTnI. Results: The values of IL-6 and IL-8 ascend gradually after CPB.The values of WBC and cTnI begin to ascend after CPB at that time, achieve the peak after CPB 24 hour, then descend. They have distinct positive correlations (P<0.01) with other examination items. Moreover their dynamic state curves are easy to be observed. The value of MYO achieves the peak twice after CPB at that time and after CPB 24 hour. Conclusion: WBC and cTnI are the preferential monitoring items of inflammatory reaction and myocardial damage for the patients undergone CABG surgery by CPB.