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[心脏外科手术干预类型及体外循环条件对心脏生物标志物围手术期动态变化的影响]

[The influence of cardiosurgical intervention type and conditions of artificial blood circulation of perioperative dynamics of cardiac biomarkers].

作者信息

Dement'eva I I, Morozov Iu A, Charnaia M A

出版信息

Khirurgiia (Mosk). 2013(2):59-62.

Abstract

125 patients after cardiac surgery operated on with the use of artificial blood circulation (ABC) were followed-up. Blood levels of cardiac protein, binding aliphatic acids and troponin 1 and 3 days after the operation were registered. The study showed that aorta clamping more then 90 minutes and hypothermic perfusion regimen influence cardiomyocites negatively. The state of "surgical trauma" and reperfusional myocardium damage was approximately the same during aortic surgery, myocardium revascularization with the use of aortic clamping and cardioplegia, and correction of the acquired heart disease, according to the dynamics of the studied proteins in blood. The minimal blood level of cardiac protein, binding aliphatic acids after coronary by-pass surgery on the working heart witnesses about negative influence of crystalloid hypothermic cardioplegia on coronary microcirculation.

摘要

对125例接受人工血液循环(ABC)心脏手术的患者进行了随访。记录了术后1天、3天心脏蛋白、结合脂肪酸和肌钙蛋白的血液水平。研究表明,主动脉阻断超过90分钟和低温灌注方案对心肌细胞有负面影响。根据血液中所研究蛋白质的动态变化,在主动脉手术、使用主动脉阻断和心脏停搏进行心肌血运重建以及后天性心脏病矫正过程中,“手术创伤”和再灌注心肌损伤的状态大致相同。在工作心脏上进行冠状动脉搭桥手术后,结合脂肪酸的心脏蛋白的最低血液水平证明了晶体低温心脏停搏对冠状动脉微循环有负面影响。

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