摘要
目的:探讨体外循环下冠状动脉旁路移植术(coronary artery bypass grafting,CABG)和非体外循环下冠状动脉旁路移植术(off-pump coronary artery bypass surgery,OPCAB)中血清基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)和炎症介质的变化规律。方法:选择择期CABG和OPCAB的患者各18例,CABG组在麻醉插管前(T0)、CPB开始后15 min(T1)、CPB结束时(T2)、CPB结束后2 h(T3)和6 h(T4)时间点采集动脉血标本,OPCAB在麻醉插管前(T0)、前降支吻合完成时(T1)、所有吻合完成时(T2)、吻合完成后2 h(T3)和6 h(T4)时间点采集动脉血标本,采用酶联免疫吸附法(enzyme-linked immunosorbent as-say,ELISA)测定血清MMP-9及炎症介质TNF-α和IL-8的含量。结果:CABG组MMP-9和TNF-α、IL-8的释放较OPCAB组明显升高(P<0.01);CABG组MMP-9、TNF-α和IL-8在体外循环结束时达到最高峰值,与CPB前相比P<0.01,之后呈下降趋势,而且MMP-9的升高与TNF-α和IL-8升高呈正相关(r值分别为0.72和0.56);OPCAB组中三者呈持续低水平上升。结论:体外循环过程可引起血清MMP-9释放增加,炎症介质TNF-α和IL-8可能对MMP-9的释放起诱导和放大作用,血清MMP-9释放可能参与体外循环术所致的全身炎症反应。
Objective: To assess the release and timing of matrix metalloproteinase-9(MMP-9)and inflammatory markers in patients taken coronary artery bypass grafting(CABG) with cardiopulmonary bypass(CPB) and off-pump coronary artery bypass surgery(OPCAB).Methods:Eighteen patients each subjected to coronary artery bypass grafting and off-pump coronary artery bypass surgery respectively were included in this study.In the CPB group,artery blood samples were collected for biochemical measurements at the following time points:immediately prior to the induction of anesthesia,15 min after initiation of CPB,termination of CPB,2 and 6 h after termination of CPB.In the OPCAB group,time points were as follows:T0,before induction of anesthesia;T1,after completion of anastomose of left anterior descending coronary atery;T2 after completion of all anastomoses;T3,at 2 h,T4,at 6 h after completion of all anastomoses.Results:The levels of MMP-9,TNF-α and IL-8 in CABG group were higher significant than in OPCAB group(P 〈 0.01).Concentration of MMP-9,TNF-α and IL-8 peaked at termination of CPB in CABG group(P 〈 0.01).The correlaton between MMP-9 and TNF-α,MMP-9 and IL-8 were significant(r,0.72 and 0.56,respectively).Conclusion:Cardiopulmonary bypass induced the release of MMP-9.TNF-α and IL-8 might amplify the release of MMP-9.The release of MMP-9 could contribute to the CPB-induced inflammatory reaction.
出处
《南京医科大学学报(自然科学版)》
CAS
CSCD
北大核心
2010年第12期1687-1690,共4页
Journal of Nanjing Medical University(Natural Sciences)
基金
国家自然科学基金资助(30972969)
关键词
冠状动脉旁路移植术
基质金属蛋白酶-9
炎症介质
coronary artery bypass grafting; matrix metalloproteinase-9; Inflammatory marker;