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冠状动脉旁路移植术中基质金属蛋白酶-9及炎症介质的释放及相关性 被引量:1

Release and correlation of matrix metalloproteinase-9 and inflammatory markers in patients undergoing coronary artery bypass grafting
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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;
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参考文献11

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同被引文献11

  • 1张美燕,郑兴.基质金属蛋白酶-9在心血管疾病中的研究进展[J].心血管病学进展,2007,28(1):88-91. 被引量:7
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  • 7Weis F,Beiras-Fernandez A,Schelling G. Stress doses of hydrocortisone in high-risk patients undergoing cardiac surgery:effects on interleukin-6 to interleukin-10 ratio and early outcome[J].Critical Care Medicine,2009,(05):1685-1690.
  • 8Orhan G,Sargin M,Senay S. Systemic and myocardial inflammation in traditional and off-pump cardiac surgery[J].Texas Heart Institute Journal,2007,(02):160-165.
  • 9Lee CW,Lin CC,Lin WN. TNF-alpha induces MMP-9 expression via activation of Src/EGFR,PDGFR/PI3K/Akt cascade and promotion of NF-kappaB/p300 binding in human tracheal smooth muscle cells[J].American Journal of Physiology-Lung Cellular and Molecular Physiology,2007,(03):799-812.
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