心脏体外循环手术前后HMGB_1、CK、CK-MB、LDH、LD_1、AST水平变化的研究

Study of heart extracorporeal circulation surgery on HMGB_1 and CK and CK-MB and LDH and LD_1 and AST levels

目的探讨体外循环手术前后患者血清HMGB1、CK、CK-MB、LDH、LD1、AST水平变化及意义。方法采用ELISA法检测57例体外循环患者手术前后血清HMGB1表达水平,采用临床常规方法检测血清中CK、CKMB、LDH、LD1、AST水平。对体外循环手术前后血清HMGB1表达水平与CK、CK-MB、LDH、LD1、AST的水平进行比较与相关分析。结果体外循环手术患者HMGB1、CK、CK-MB、LDH、LD1、AST水平在手术后0.5小时、24小时、48小时、72小时均高于手术前(P<0.05);HMGB1、CK、CK-MB、LD1、AST水平在手术后24小时达高峰,LDH水平高峰出现于手术后48小时,其他各指标渐渐下降。体外循环手术阻断时间延长,则HMGB1、CK、CK-MB、LDH、LD1、AST水平升高。体外循环手术后患者血清中HMGB1表达水平与CK、CK-MB、LDH、AST指标呈正相关关系(P<0.05)。结论体外循环手术后患者血清HMGB1、CK、CK-MB、LDH、LD1、AST水平升高,HMGB1参与了心肌的缺血再灌注损伤过程。

Objective To investigate before extracorporeal circulation and after HMGB1 , CK, CK-MB, LDH, LD1 , AST levels and significance in serum of patients. Methods 57 cases before extracorporeal circulation surgery and after, the levels of HMGB1 were detected by ELISA, while the levels of CK and CK-MB and LDH and LD1 and AST were detected by using conventional methods of clinical. Difference of I-IMGB1 and CK, CK-MB, LDH, LD1 and AST levels were compared. The relationship were been analyzed on the patients before extracorporeal circulation surgery and after. Results In extracorporeal circulation surgery, HMGBl , CK, CK-MB, LDH, LD1 , AST levels after surgery in 0. 5 hours, 24 hours, 48 hours, 72 hours were higher than before surgery （P 〈0. 05） ; HMGB1 , CK, CK-MB, LD1 , AST levels peaked at 24 hours after surgery, LDH levels was peaked at 48 hours after surgery, and then gradually declined. Extracorporeal circulation blocking was prolonged, the levels of HMGB1 and CK and CK-MB and LDH and LDI and AST were elevated. After extracorporeal circulation surgery in serum the levels of HMGB1 expression and CK, CK-MB, LDH, AST indicators showed a positive correlation （P 〈 0. 05） . Conclusion The levels of HMGB1, CK, CK-MB, LDH, LD1 and AST were elevated after extracorporeal circulation surgery. HMGB1 was involved in myocardial ischemia and reperfusion injury.