中性粒细胞减少可降低心肌再灌注发病率。

Neutrophil depletion reduces myocardial reperfusion morbidity.

作者信息

Palatianos George M, Balentine Gilbert, Papadakis Emmanuel G, Triantafillou Constantine D, Vassili Mary I, Lidoriki Angela, Dinopoulos Athanasios, Astras George M

机构信息

Third Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.

出版信息

Ann Thorac Surg. 2004 Mar;77(3):956-61. doi: 10.1016/j.athoracsur.2003.10.004.

DOI:10.1016/j.athoracsur.2003.10.004

PMID:14992906

Abstract

BACKGROUND

We tested the hypothesis that depletion of neutrophil leukocytes from the cardioplegic and the initial myocardial reperfusion perfusates reduces clinical indices of reperfusion injury in patients undergoing elective coronary artery bypass.

METHODS

We studied 160 consecutive patients who underwent standard coronary revascularization with cardiopulmonary bypass. Patients with recent myocardial infarction or coronary angioplasty were excluded. Cold blood cardioplegia was used. Just before aortic unclamping, the hearts were perfused retrograde with 250 mL of normothermic cardioplegic solution and 750 mL of blood (pump perfusate). Patients were randomly assigned to two groups. In 80 patients (treated), neutrophils and platelets were removed from all cardiac perfusate during aortic crossclamping with leukocyte filtration. In the remaining 80 patients (control group), leukocyte filtration was not used.

RESULTS

There was no significant difference between groups in age, sex, severity of disease, and number of bypass grafts implanted. Treated patients showed lower prevalence of low cardiac index and reperfusion ventricular fibrillation and lower levels of creatinine kinase MB isoenzyme and troponin I early postoperatively (p < 0.05).

CONCLUSIONS

Neutrophil-filtered blood cardioplegia/reperfusion significantly reduced clinical and biochemical indices of myocardial reperfusion injury after elective coronary revascularization with cardiopulmonary bypass.

摘要

背景

我们检验了如下假设，即从心脏停搏液和初始心肌再灌注灌注液中去除中性粒细胞可降低择期冠状动脉搭桥患者再灌注损伤的临床指标。

方法

我们研究了160例连续接受标准冠状动脉血运重建并使用体外循环的患者。排除近期发生心肌梗死或接受过冠状动脉血管成形术的患者。采用冷血心脏停搏液。在主动脉阻断即将解除前，用250 mL常温心脏停搏液和750 mL血液（泵灌注液）逆行灌注心脏。患者被随机分为两组。80例患者（治疗组）在主动脉交叉阻断期间通过白细胞过滤从所有心脏灌注液中去除中性粒细胞和血小板。其余80例患者（对照组）未使用白细胞过滤。