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不停跳与停跳冠状动脉旁路移植术:基于肿瘤坏死因子-α或C反应蛋白的术后早期肾功能无差异。

On-versus Off-Pump Coronary Artery Bypass Grafting: No Difference in Early Postoperative Kidney Function Based on TNF-α or C-Reactive Protein.

作者信息

Nezami Nariman, Djavadzadegan Hassan, Tabatabaie-Adl Haleh, Hamdi Amir, Ghobadi Kazem, Ghorashi Sona, Hajhosseini Babak

机构信息

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Cardiorenal Med. 2012 Aug;2(3):190-199. doi: 10.1159/000339171. Epub 2012 Jun 27.

Abstract

BACKGROUND/AIMS: There are controversial data about renal function following off-pump coronary artery bypass grafting (CABG). The present study aimed to evaluate renal function changes 24 h after on- and off-pump CABG, as well as renal function correlated with high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α). METHODS: Ninety patients with coronary artery disease referred to our center for CABG from July 2006 to November 2007 were enrolled in the study. Patients were equally and randomly divided in two groups, on- and off-pump. Serum levels of creatinine (Cr), blood urea nitrogen, creatinine clearance (CrCl), hs-CRP, and TNF-α were determined immediately before and 24 h after surgery. RESULTS: Cr and CrCl changes after surgery were not significantly different between the two groups; however, blood urea nitrogen levels after surgery were significantly higher in the on-pump group (p = 0.035). No statistically significant difference was noted between the two groups in terms of changes in levels of hs-CRP and TNF-α (p = 0.350 and 0.805, respectively). The changes in CrCl levels had no significant correlation with hs-CRP and TNF-α. CONCLUSIONS: The early Cr and CrCl levels after surgery are not significantly different in on- and off-pump groups. The early renal function after on- or off-pump CABG is not correlated with the levels of inflammatory markers including hs-CRP and TNF-α.

摘要

背景/目的:关于非体外循环冠状动脉旁路移植术(CABG)后肾功能的数据存在争议。本研究旨在评估体外循环和非体外循环CABG术后24小时的肾功能变化,以及与高敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)相关的肾功能。方法:2006年7月至2007年11月转诊至本中心接受CABG的90例冠心病患者纳入研究。患者被平均随机分为两组,即体外循环组和非体外循环组。在手术前即刻和术后24小时测定血清肌酐(Cr)、血尿素氮、肌酐清除率(CrCl)、hs-CRP和TNF-α水平。结果:两组术后Cr和CrCl变化无显著差异;然而,体外循环组术后血尿素氮水平显著更高(p = 0.035)。两组hs-CRP和TNF-α水平变化无统计学显著差异(分别为p = 0.350和0.805)。CrCl水平变化与hs-CRP和TNF-α无显著相关性。结论:体外循环组和非体外循环组术后早期Cr和CrCl水平无显著差异。体外循环或非体外循环CABG术后早期肾功能与包括hs-CRP和TNF-α在内的炎症标志物水平无关。

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