Department of Physiotherapy, Kainan Hospital, Yatomi, Aichi, Japan.
J Crit Care. 2010 Mar;25(1):172.e1-8. doi: 10.1016/j.jcrc.2009.05.012. Epub 2009 Aug 13.
The present study was performed to clarify the relationships between body mass index (BMI), interleukin-6 (IL-6) production, and respiratory muscle weakness in patients undergoing coronary artery bypass grafting (CABG).
The correlations among BMI, changes in maximum inspiratory and expiratory pressure (DeltaMIP, DeltaMEP) on postoperative days (POD) 1 and 7, postoperative IL-6, and rapid turnover proteins (retinol-binding protein, prealbumin, and transferrin) on POD1 were assessed in 154 consecutive patients undergoing elective CABG. The patients were divided into quartiles of BMI, Q1 (BMI, <20.8 kg/m(2)) to Q4 (BMI, > or =25.25 kg/m(2)), and compared among groups.
There were significant correlations between DeltaMIP and BMI (POD1, r = -0.369; POD7, r = -0.285) and IL-6 (POD1, r = 0.423; POD7, r = 0.431), and between DeltaMEP and BMI (POD1, r = -0.252; POD7, r = -0.228) and IL-6 (POD1, r = 0.252; POD7, r = 0.384). Interleukin-6 showed a significant negative correlation with BMI (r = -0.374) and retinol-binding protein (r = -0.382). Interleukin-6 was highest in Q1 and lowest in Q4. Higher BMI indicated greater respiratory muscle strength than lower BMI.
Preoperative BMI is correlated with respiratory muscle strength and cytokine production after CABG. The findings of this study suggest that BMI may be a valuable predictor for respiratory management in CABG patients.
本研究旨在阐明体重指数(BMI)、白细胞介素-6(IL-6)产生与行冠状动脉旁路移植术(CABG)患者呼吸肌无力之间的关系。
本研究共纳入 154 例行择期 CABG 的连续患者,评估了术后第 1 天(POD)和第 7 天(POD)最大吸气和呼气压力变化(DeltaMIP、DeltaMEP)、术后第 1 天(POD1)IL-6 与快速转化蛋白(视黄醇结合蛋白、前白蛋白和转铁蛋白)之间的相关性。患者按 BMI 分为四分位数,Q1(BMI,<20.8kg/m(2))至 Q4(BMI,>=25.25kg/m(2)),并对各组进行比较。
DeltaMIP 与 BMI(POD1,r=-0.369;POD7,r=-0.285)和 IL-6(POD1,r=0.423;POD7,r=0.431)之间存在显著相关性,DeltaMEP 与 BMI(POD1,r=-0.252;POD7,r=-0.228)和 IL-6(POD1,r=0.252;POD7,r=0.384)之间存在显著相关性。IL-6 与 BMI(r=-0.374)和视黄醇结合蛋白(r=-0.382)之间存在显著负相关。Q1 组的 IL-6 最高,Q4 组的 IL-6 最低。较高的 BMI 表明呼吸肌力量比较低的 BMI 更强。
术前 BMI 与 CABG 后呼吸肌力量和细胞因子产生相关。本研究结果提示 BMI 可能是 CABG 患者呼吸管理的一个有价值的预测指标。