Matheis G, Scholz M, Gerber J, Abdel-Rahman U, Wimmer-Greinecker G, Moritz A
Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt, Germany.
Perfusion. 2001 Jan;16(1):43-9. doi: 10.1177/026765910101600107.
Improved myocardial protection and cardiopulmonary bypass (CPB) have limited, but not abolished, intraoperative myocardial damage due to surgical reperfusion injury after release of the aortic crossclamp. In this double-blind, randomized study, we evaluated whether short-term leukocyte filtration during reperfusion may further reduce myocardial damage. Thirty-eight patients with coronary artery disease were randomly assigned to CPB with (group I; n = 19) or without leukocyte filtration (group II; n = 19). There was no difference in bypass time or crossclamp time between the groups. No patient in group I required catecholamines, whereas three patients in group II were supported with adrenaline or dobutamine on the first and second postoperative day. In addition, troponin T plasma levels were lower in group I (p < 0.05), whereas other markers for tissue injury (CK, CK-MB, LDH, S-GOT and S100B) did not differ. In conclusion, leukocyte filtration during reperfusion may further improve CPB by reducing myocardial damage.
改善后的心肌保护和体外循环（CPB）虽已限制但未消除主动脉阻断钳松开后手术再灌注损伤所致的术中心肌损伤。在这项双盲随机研究中，我们评估了再灌注期间短期白细胞滤过是否可进一步减轻心肌损伤。38例冠心病患者被随机分为接受白细胞滤过的CPB组（I组；n = 19）和未接受白细胞滤过的CPB组（II组；n = 19）。两组间的体外循环时间或阻断钳时间无差异。I组无患者需要使用儿茶酚胺，而II组有3例患者在术后第1天和第2天接受了肾上腺素或多巴酚丁胺支持治疗。此外，I组肌钙蛋白T血浆水平较低（p < 0.05），而其他组织损伤标志物（CK、CK-MB、LDH、S-GOT和S100B）无差异。总之，再灌注期间白细胞滤过可通过减轻心肌损伤进一步改善CPB。
