体外循环与非体外循环冠状动脉旁路移植术循环-南方医科大学学报.pdfVIP

2011;31(3) 南方医科大学学报（J South Med Univ ） ·535 · ·临床研究· 体外循环与非体外循环冠状动脉旁路移植术循环内皮细胞损伤 的研究 宋铁牛，赵启明，高秉仁 兰州大学第二医院心外科，甘肃 兰州 730030 摘要：目的通过研究循环内皮细胞（CECs）数量和形态的改变，探讨体外与非体外冠状动脉旁路移植术中CECs 的损伤有 无差异。方法将48 例需行冠状动脉旁路移植术的冠状粥样硬化疾病患者随机分为两组，分别接受体外与非体外循环下 的手术治疗；在麻醉前、手术结束时、术后1d、3 d 抽血，采用标记特异性抗体CD146 的免疫磁珠技术分离CECs并计数；同 时应用单细胞凝胶电泳技术观察CECs 的DNA 损伤程度。结果体外循环组CECs 数量在手术结束及术后1天均显著高 于非体外循环组（P0.05），在术后3d ，CECs 数量两组无显著性差异（P0.05）；手术结束时体外循环组“彗尾”长度明显增 长，荧光强度变大。结论体外循环较非体外循环冠状动脉旁路移植术相比，循环内皮细胞损伤严重；这些变化和预后有 密切关系。 关键词：血管内皮细胞；冠心病；体外循环 中图分类号：R615 文献标志码：A 文章编号：1673-4254(2011)03-0535-04 Circulating endothelial cell injury in on-pump and off-pump coronary-artery bypass grafting SONG Tie-niu, GAO Bing-ren, ZHAO Qi-ming Department of Cardiothoracic Surgery, Second Hospital of Lanzhou University, Lanzhou 730030, China Abstract: Objective To investigate the difference in circulating endothelial cell (CECs) injuries following on-pump and off-pump coronary-artery bypass surgery. Methods We randomly assigned 48 patients scheduled for urgent or elective coronary artery bypass grafting into two groups to receive on-pump and off-pump procedures. Blood samples were obtained before anesthesia, at the end of operation, and on days 1 and 3 after the operation, and CECs were isolated and counted using dynabeads coated with the specific antibody of CD146. Single cell gel electrophoresis was used to observe the morphological changes of the CECs. Results In the cardiopulmonary bypass (CPB) group, the number of CECs was significantly greater than that in non-CPB group (P0.05) at the end of