两种心脏手术方式对中性粒细胞CD11b丙二醛及心肌酶影响的对比研究.docVIP

KKME---专业医学搜索引擎/ 两种心脏手术方式对中性粒细胞 CD11b、丙二醛及心肌酶影响的对比研究 作者:阎志军,赵志勇,赵砚丽 作者单位：河北省人民医院心血管外科，河北 石家庄 050051 【摘要】 目的 探讨停跳和不停跳心内直视手术对外周血中性粒细胞（PMN） CD11b表达、血浆丙二醛（MDA）和血清心肌酶水平的影响。方法 32例先天性心脏病患者分为不停跳组（n=15）和停跳组（n=17）。在不同时间点采静脉血测定PMN CD11b表达、血浆MDA水平和血清心肌酶水平。结果 两组PMN CD11b和血浆MDA水平在体外循环开始后均显著升高，在体外循环结束后停跳组显著高于不停跳组。术后血清心肌酶水平停跳组显著高于不停跳组。结论 体外循环本身可导致PMN CD11b和血浆MDA的升高，而缺血再灌注损伤可使PMN CD11b、血浆MDA进一步增高；不停跳手术的心肌保护效果优于停跳手术。 【关键词】 心脏不停跳；缺血再灌注损伤；中性粒细胞；CD11b 　　Comparative Study of the Effection to the Expression of Polymorphonuclear Neutrophil CD11b, Plasma MDA and Serum Myocardiac Enzymes in Peripheral Blood by Different Open Heart Operation Style 　　YAN Zhi-jun,ZHAO Zhi-yong,ZHAO Yan-li,HE Rong-hai,GAO Yong-qian,YU Xin-jiang,XIE Shu-fang,FENG Guang-xing 　　(Department of Cardiovascular Surgery,HeBei Peoples Provincial Hospital,Hebei ShiJiazhuang 050051,China) 　　Abstract: OBJECTIVE To observe the influence of the open heart operation under arrested-heart and on-pump beating-heart to the expression of polymorphonuclear neutrophil (PMN) CD11b, plasma malondialdehyde （MDA） concentration and myocardiac enzymes in peripheral blood. METHODS Thirty-two patients underwent open heart operation were divided into two groups as they were performed under on-pump beating-heart (Group 1, n=15) or arrested-heart (Group 2, n=17). The venous blood was drawn to detect the expression of PMN CD11b, plasma MDA concentration and serum myocardiac enzymes. RESULTS Expression of PMN CD11b and plasma MDA concentration were statistically higher after extracorporeal circulation（ECC） compared with preoperative time in both groups. But it was higher of group 2 than that of group 1 after ECC was stopped. Concentration of serum myocardiac enzymes of group 1 were higher than that of group 2. CONCLUSION ECC itself can cause the up-regulation of PMN CD11b and increase of plasma MDA concentration，but the ischemia reperfusion injury of myocardium can cause further increases of them. The myoc