Bayram H, Erer D, Iriz E, Zor M H, Gulbahar O, Ozdogan M E
Department of Cardiovascular Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.
Perfusion. 2012 Jan;27(1):56-64. doi: 10.1177/0267659111424639. Epub 2011 Oct 14.
We aimed to investigate the effects of off-pump coronary artery bypass grafting, pulsatile cardiopulmonary bypass, and non-pulsatile cardiopulmonary bypass techniques on the inflammatory response and the central nervous system in the current study.
A total of 32 patients who were scheduled for elective coronary artery bypass graft surgery were included in the study. The patients were allocated into three different groups according to the perfusion techniques used during the cardiopulmonary bypass procedure as follows: off-pump coronary artery bypass grafting group (n=10); pulsatile cardiopulmonary bypass group (n=11); and non-pulsatile cardiopulmonary bypass group (n=11). Serum interleukin-6, interleukin-8, tumor necrosis factor-alpha and S-100beta levels were measured preoperatively, and at 0, 6, and 24 hours postoperatively.
The postoperative increase in the levels of interleukin-6 and interleukin-8 was significantly lower in the off-pump group compared to the other two groups (p<0.05), while there was no significant difference in tumor necrosis factor-alpha levels between the groups. Postoperative S-100β levels, an indicator of cerebral injury, was significantly lower in the off-pump CABG group compared to the other two groups (p<0.05).
We found that off-pump coronary artery bypass grafting had less negative effects on inflammatory response and central nervous system compared to pulsatile cardiopulmonary bypass and non-pulsatile cardiopulmonary bypass techniques.
在本研究中，我们旨在探讨非体外循环冠状动脉搭桥术、搏动性体外循环和非搏动性体外循环技术对炎症反应和中枢神经系统的影响。
本研究共纳入32例计划进行择期冠状动脉搭桥手术的患者。根据体外循环过程中使用的灌注技术，将患者分为三个不同的组，如下：非体外循环冠状动脉搭桥术组（n = 10）；搏动性体外循环组（n = 11）；非搏动性体外循环组（n = 11）。术前、术后0小时、6小时和24小时测量血清白细胞介素-6、白细胞介素-8、肿瘤坏死因子-α和S-100β水平。
与其他两组相比，非体外循环组术后白细胞介素-6和白细胞介素-8水平的升高显著更低（p < 0.05），而各组之间肿瘤坏死因子-α水平无显著差异。作为脑损伤指标的术后S-100β水平，非体外循环冠状动脉搭桥术组显著低于其他两组（p < 0.05）。
我们发现，与搏动性体外循环和非搏动性体外循环技术相比，非体外循环冠状动脉搭桥术对炎症反应和中枢神经系统的负面影响更小。
