Liu Yin-he, Zhou Yi-wen, Tu Zhi-guang, Ji Shang-yi, Chen Man, Huang Zhi-yong, Yang Jian-an, Renneberg R, Wang Yi, Nie Zhi-yong, Zhong An
Department of Laboratory Medicine, Chongqing Medical University, Chongqing 400016, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Jun;38(6):514-7.
To evaluate the value of human fatty acid binding protein (h-FABP) in predicting myocardial ischemia and injury in the perioperative period of cardiac surgery, we observed the dynamic changes of h-FABP in perioperative period of patients underwent coronary artery bypass grafting and ventricular septal defects repairing surgery, and evaluated the relationship of h-FABP and ischemia modified albumin (IMA), CK-MB, cTnI.
Patients underwent coronary artery bypass grafting (n=30) and ventricular septal defect repairing (n=30) surgery between February 2008 and December 2008 were included in this study. Venous blood sample was obtained at preoperative, aortic clamping, aortic unclamping of 10 min, 2 h, 6 h, 12 h, 24 h for the measurements of h-FABP, IMA, cTnI and CK-MB.
h-FABP and IMA changed in the same way at various examined time points, h-FABP changes also paralleled cTnI and CK-MB changes, h-FABP peaked early during myocardial ischemia and injury and returned to baseline level at 2 h post myocardial ischemia and injury. Linear correlation analysis showed that the peak value of h-FABP was positively correlated with IMA, CK-MB and cTnI in both CABG group (r = 0.948, 0.964 and 0.961, P < 0.05) and in the VSD group (r = 0.986, 0.978 and 0.957).
h-FABP is an early diagnostic parameter reflecting perioperative myocardial ischemia and injury in cardiac surgery. Quantitative h-FABP monitoring could predict the severity of myocardial ischemia and injury early during cardiac surgery.
为评估人脂肪酸结合蛋白(h-FABP)在心脏手术围术期预测心肌缺血及损伤中的价值,我们观察了行冠状动脉旁路移植术及室间隔缺损修补术患者围术期h-FABP的动态变化,并评估了h-FABP与缺血修饰白蛋白(IMA)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)的关系。
本研究纳入2008年2月至2008年12月期间行冠状动脉旁路移植术(n = 30)及室间隔缺损修补术(n = 30)的患者。于术前、主动脉阻断时、主动脉开放10分钟、2小时、6小时、12小时、24小时采集静脉血样本,测定h-FABP、IMA、cTnI及CK-MB。
在各个检测时间点,h-FABP与IMA变化趋势相同,h-FABP变化也与cTnI及CK-MB变化平行,h-FABP在心肌缺血及损伤早期达到峰值,并在心肌缺血及损伤后2小时恢复至基线水平。线性相关分析显示,在冠状动脉旁路移植术组(r = 0.948、0.964及0.961,P < 0.05)及室间隔缺损组(r = 0.986、0.978及0.957)中,h-FABP峰值均与IMA、CK-MB及cTnI呈正相关。
h-FABP是反映心脏手术围术期心肌缺血及损伤的早期诊断指标。定量监测h-FABP可在心脏手术早期预测心肌缺血及损伤的严重程度。