Mei Yun-qing, Lu Ya-feng, Tang Chu-zhong, Wu Ming-ying, Hu Da-yi
Heart-Lung-Blood-vessel Center, Institute of Heart-Lung-Blood-vessel Disease, Department of Thoracic-Cardiovascular Surg., Tongji Hospital, Tongji University, Shanghai 200092, China.
Zhonghua Yi Xue Za Zhi. 2006 Jul 25;86(28):1997-9.
To compare the influences of coronary artery bypass grafting under on-pump (CCABG) and off-pump bypass (OPCAB) on blood lipids and Apolipoproteins A(1) and B.
41 patients underwent CCABG and 38 patients OPCAB. The serum levels of total cholesterol (TC), triglycerides (TG), HDL-C cholesterol (HDL-C), LDL-C cholesterol (LDL-C) and Apolipoproteins A(1) and B were monitored before and 24 h, 72 h, 7 d, 10 d, 14 d, 28 d after operation in all patients. None of them received lipid-lowering drug during the test.
(1) There were no difference between two groups. The serum levels of TC, LDL-C decreased significantly in 24 h, 72 h, 7d, 10 d, 14 d after operation (P < 0.001). The level in 24 h was the lowest, then began increasing; until 28 days after operation the serum levels of TC, LDL-C exceeded preoperative baseline level (P < 0.05). (2) the level of TG and HDL-C in 24 h was the lowest (P < 0.001), then began increasing (P > 0.05). Until 28 days after operation the serum levels of TG exceeded preoperative baseline level (P < 0.05). (3) the serum levels of ApoA(1) decreased significantly in 24 h, 72 h, 7 day, 10 day, 14 day after operation (P < 0.001). The level in 24 h was the lowest, and lasted until 28 days after operation (P > 0.05); the serum levels of ApoB in 24 h was the lowest, then began increasing (P > 0.05).
There presents significant influence on blood lipids and Apolipoproteins A(1) and B after CABG, and initiate lipid (s)-lowering therapy as soon as possible.
比较体外循环冠状动脉旁路移植术（CCABG）和非体外循环冠状动脉旁路移植术（OPCAB）对血脂及载脂蛋白A(1)和B的影响。
41例行CCABG患者和38例行OPCAB患者。所有患者在术前、术后24小时、72小时、7天、10天、14天、28天监测血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）以及载脂蛋白A(1)和B水平。试验期间均未接受降脂药物治疗。
（1）两组间无差异。术后24小时、72小时、7天、10天、14天血清TC、LDL-C水平显著降低（P<0.001）。24小时时最低，随后开始升高；至术后28天血清TC、LDL-C水平超过术前基线水平（P<0.05）。（2）24小时时TG和HDL-C水平最低（P<0.001），随后开始升高（P>0.05）。至术后28天血清TG水平超过术前基线水平（P<0.05）。（3）术后24小时、72小时、7天、10天、14天血清ApoA(1)水平显著降低（P<我们的001）。24小时时最低，持续至术后28天（P>0.05）；24小时时血清ApoB水平最低，随后开始升高（P>0.05）。
冠状动脉旁路移植术后对血脂及载脂蛋白A(1)和B有显著影响，应尽早启动降脂治疗。
