两种冠状动脉旁路移植术对围术期患者血浆特异性烯醇化酶和S100蛋白的影响

Effects of on-pump and off-pump coronary artery bypass grafting on plasma neuron specific enolase and S100 protein levels

目的探讨体外循环和非体外循环下冠状动脉旁路移植术对围术期血浆特异性烯醇化酶(NSE)、S100蛋白(S100)的影响。方法选取择期行冠状动脉移植术患者50例,随机分为体外循环下手术组和非体外循环下手术组,每组25例。于术前(T1)、术后即刻(T2)、术后6h(T3)、术后24h(T4)和术后48h(T5)抽取血样本,采用放射免疫法检测各时间点血浆中NSE、S100蛋白含量。结果术前NSE、S100蛋白含量组间差异无统计学意义(P>0.05),2组术后即刻NSE、S100蛋白浓度均明显升高,但体外组升幅明显大于非体外组,差异有统计学意义(P<0.05);体外组和非体外组术后6h浓度开始下降,并延续至24h后,术后48h非体外组基本恢复至术前水平,而体外组尚处于较高水平。结论体外循环和非体外循环冠状动脉旁路移植术均可引起血浆NSE、S100蛋白水平升高,但非体外循环冠状动脉旁路移植术对其影响较小。

Objective To investigate the effects of on-pump and off-pump coronary artery bypass grafting on plasma neuron specific enolase（NSE）and S100 protein levels before and after operation in elderly patients.Methods Fifty patients with coronary artery bypass grafting were enrolled in the study and divided into on-pump and off-pump group,each group had 25 cases.Blood samples were collected before surgery,immediately after operation,6 h,24 h and 48 h after operation.The plasma levels of NSE and S100 protein were detected by radio immunoassay.Results There were no significant differences between the two groups in the levels of NSE and S100 protein before operation.The 1evels of NSE and S100 protein were significantly increased immediately after operation in the two groups of on-and off-pump,and the plasma levels of NSE and S100 in on-pump group protein increased more significantly than off-pump gro up（P0.05）.The plasma 1evels of NSE and S100 protein began to decline at 6 hours after operation,and continued to 24 hours after operation.On 48 hours after operation,the plasma 1evels of NSE and S100 protein in off-pump group returned to the preoperative 1evel,but they were still maintained at a high 1evel in on-pump group.Conclusion For the patients,both on-pump and off-pump coronary artery bypass grafting can increase plasma levels of NSE and S100 protein.But compared with the on-pump coronary artery bypass grafting,the off-pump coronary artery bypass grafting has 1ess influence.