Patris Emmanuel, Giakoumidakis Konstantinos, Patris Vasileios, Kuduvalli Manoj, Argiriou Mihalis, Charitos Christos, Kalaitzis Christos, Touloupidis Stavros
Department of Urology, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece.
Department of Cardiac Surgery, Cardiac Surgery ICU, "Evangelismos" General Hospital of Athens, Greece.
Urol Ann. 2015 Jan-Mar;7(1):58-62. doi: 10.4103/0974-7796.148619.
The purpose of this study is to compare the perioperative total prostate specific antigen (tPSA) levels among coronary artery bypass grafting (CABG) patients with and without extracorporeal circulation (ECC), to investigate the changes overtime of tPSA in each group separately and to determine the effect of body core temperature on tPSA levels.
A prospective study was conducted. Our sample was allocated to: (a) Seven patients who underwent off pump CABG (Group I) and (b) 16 CABG patients with ECC (Group II). The levels of tPSA were measured preoperatively (baseline), intra-operatively and at the 4(th) postoperative day. We compared the two groups on their tPSA levels and we investigated the changes of tPSA overtime in each group separately.
Intra-operative serum samples were obtained in significantly lower body temperature in patients of Group II than in those of Group I (31°C vs. 36.9°C, P < 0.001). In each group separately, postoperative tPSA levels were increased significantly compared to the baseline values (2.55 ng/ml vs. 0.39 ng/ml for Group I, P = 0.005 and 4.36 ng/ml vs. 0.77 for Group II, P < 0.001). CABG patients with ECC had significantly lower intra-operative tPSA levels than the baseline values (0.67 ng/ml vs. 0.77 ng/ml, P = 0.008). We did not observe significant differences of tPSA levels between the two groups.
CABG surgery affects similarly the perioperative tPSA independently the involvement of ECC. Although all patients had significantly higher early postoperative tPSA levels, only those who underwent CABG with ECC had exceeded normal values and significantly decreased intra-operative tPSA. Hypothermia seems to be the causal factor of tPSA reduction.
本研究旨在比较接受冠状动脉旁路移植术（CABG）且有或无体外循环（ECC）的患者围手术期总前列腺特异性抗原（tPSA）水平，分别研究每组中tPSA随时间的变化，并确定体核心温度对tPSA水平的影响。
进行了一项前瞻性研究。我们的样本分为：（a）7例行非体外循环CABG的患者（第一组）和（b）16例行体外循环CABG的患者（第二组）。在术前（基线）、术中及术后第4天测量tPSA水平。我们比较了两组的tPSA水平，并分别研究了每组中tPSA随时间的变化。
第二组患者术中采集血清样本时的体温明显低于第一组患者（31°C对36.9°C，P<0.001）。分别在每组中，术后tPSA水平与基线值相比显著升高（第一组为2.55 ng/ml对0.39 ng/ml，P = 0.005；第二组为4.36 ng/ml对0.77，P<0.001）。行体外循环CABG的患者术中tPSA水平明显低于基线值（0.67 ng/ml对0.77 ng/ml，P = 0.008）。我们未观察到两组之间tPSA水平有显著差异。
CABG手术对围手术期tPSA的影响相似，与是否使用体外循环无关。尽管所有患者术后早期tPSA水平均显著升高，但只有接受体外循环CABG的患者tPSA超过正常值且术中tPSA显著降低。体温过低似乎是tPSA降低的原因。
