Mazzone Annette L, Baker Robert A, McNicholas Kym, Woodman Richard J, Michael Michael Z, Gleadle Jonathan M
Cardiac Surgery Research and Perfusion, Cardiac and Thoracic Surgical Unit, Flinders Medical Centre, Adelaide, Australia.
School of Medicine, Flinders University, Adelaide, Australia.
J Extra Corpor Technol. 2018 Mar;50(1):19-29.
A pilot study to measure and compare blood and urine microRNAs miR-210 and miR-16 in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and off-pump coronary artery bypass grafting surgery. Frequent serial blood and urine samples were taken from patients undergoing cardiac surgery with CPB (n = 10) and undergoing off-pump cardiac surgery (n = 5) before, during, and after surgery. Circulating miR-210 and miR-16 levels were determined by relative quantification real-time polymerase chain reaction. Levels of plasma-free haemoglobin (fHb), troponin-T, creatine kinase, and creatinine were measured. Perioperative serum miR-210 and miR-16 were elevated significantly compared to preoperative levels in patients undergoing cardiac surgery with CPB (CPB vs. Pre Op and Rewarm vs. Pre Op; < .05 for both). There were increases of greater than 200% in miR-210 levels during rewarming and immediately postoperatively and a 3,000% increase in miR-16 levels immediately postoperatively in urine normalized to urinary creatinine concentration. Serum levels of miR-16 were relatively constant during off-pump surgery. miR-210 levels increased significantly in off-pump patients perioperatively ( < .05 Octopus on vs. Pre Op); however, the release was less marked when compared to cardiac surgery with CPB. A significant association was observed between both miR-16 and miR-210 and plasma fHb when CPB was used ( = -.549, < .0001 and = -.463, < .0001 respectively). Serum and urine concentrations of hypoxically regulated miR-210 and hemolysis-associated miR-16 increased in cardiac surgery using CPB compared to off-pump surgery. These molecules may have utility in indicating severity of cardiac, red cell, and renal injury during cardiac surgery.
一项针对接受体外循环（CPB）心脏手术和非体外循环冠状动脉搭桥手术患者的血液和尿液中微小RNA miR-210和miR-16进行测量和比较的初步研究。对接受CPB心脏手术（n = 10）和非体外循环心脏手术（n = 5）的患者在手术前、手术期间和手术后频繁采集系列血液和尿液样本。通过相对定量实时聚合酶链反应测定循环miR-210和miR-16水平。测量无血浆血红蛋白（fHb）、肌钙蛋白-T、肌酸激酶和肌酐水平。与术前水平相比，接受CPB心脏手术的患者围手术期血清miR-210和miR-16显著升高（CPB与术前以及复温与术前相比；两者均P <.05）。复温期间和术后即刻miR-210水平增加超过200%，尿液中miR-16水平术后即刻相对于尿肌酐浓度增加3000%。非体外循环手术期间血清miR-16水平相对恒定。非体外循环患者围手术期miR-210水平显著升高（章鱼阻断时与术前相比P <.05）；然而，与CPB心脏手术相比，其释放不太明显。使用CPB时，miR-16和miR-210与血浆fHb之间均观察到显著相关性（分别为r = -.549，P <.0001和r = -.463，P <.0001）。与非体外循环手术相比，CPB心脏手术中缺氧调节的miR-210血清和尿液浓度以及溶血相关的miR-16增加。这些分子可能有助于指示心脏手术期间心脏、红细胞和肾脏损伤的严重程度。
