成人体外循环后全身血管生成素-1/2失调
Systemic angiopoietin-1/2 dysregulation following cardiopulmonary bypass in adults.
作者信息
Charbonney Emmanuel, Wilcox Elizabeth, Shan Yuexin, d'Empaire Pablo Perez, Duggal Abhijit, Rubenfeld Gordon D, Liles Conrad, Santos Claudia Dos
机构信息
Centre de Recherche de l'Hôpital du Sacré-Coeur, University of Montreal, 5400 Boulevard Gouin Ouest, Montréal, QC H4J 1C5, Canada; Centre de Recherche de l'Hôpital du Sacré-Coeur, University of Montreal, 5400 Boulevard Gouin Ouest, Montréal, QC H4J 1C5, Canada.
Interdepartmental Division of Critical Care, University of Toronto, University Health Network, 399 Bathurst St, Toronto, ON M5T 2S8, Canada; Interdepartmental Division of Critical Care, University of Toronto, University Health Network, 399 Bathurst St, Toronto, ON M5T 2S8, Canada.
出版信息
Future Sci OA. 2017 Jan 11;3(1):FSO166. doi: 10.4155/fsoa-2016-0072. eCollection 2017 Mar.
AIM
Vascular leakage following cardiopulmonary bypass contributes to morbidity. Angiopoietin-1 and -2 are biomarkers of endothelial dysfunction. Our aim was to characterize Ang-1 and -2 association with clinical characteristics and outcomes.
METHODS
Observational cohort study measuring Ang-1/-2 with a panel of cytokines in adults undergoing cardiopulmonary bypass.
RESULTS
Ang-2 levels increased immediately postop whereas Ang-1 levels decreased over time. No significant correlation was found with other inflammatory mediators. High correlation was found between the hospital length of stay and Ang-2 increase at 24 h (rho = 0.590; p < 0.0001). The predictors of Ang-2 increase were female gender, cross clamp time, transfusion of blood and absence of angiotensin-converting enzyme inhibitor as a pre-op medication.
CONCLUSION
Angiopoietins can detect vascular leakage early and could impact patient's management to decrease length of stay after cardiac surgery.
目的
体外循环后的血管渗漏会导致发病。血管生成素-1和-2是内皮功能障碍的生物标志物。我们的目的是明确血管生成素-1和-2与临床特征及预后的关联。
方法
在接受体外循环的成人中进行观察性队列研究，同时检测血管生成素-1/-2及一组细胞因子。
结果
术后即刻血管生成素-2水平升高，而血管生成素-1水平随时间下降。未发现其与其他炎症介质有显著相关性。住院时间与术后24小时血管生成素-2升高之间存在高度相关性（rho = 0.590；p < 0.0001）。血管生成素-2升高的预测因素为女性、主动脉阻断时间、输血以及术前未使用血管紧张素转换酶抑制剂。
结论
血管生成素能够早期检测血管渗漏，并可能影响患者管理，以缩短心脏手术后的住院时间。
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