在异氟烷预处理的非体外循环冠状动脉旁路移植术（OPCABG）中左内乳动脉（LIMA）的RhoA/ Rho激酶、一氧化氮与炎症反应
RhoA/rho-kinase, nitric oxide and inflammatory response in LIMA during OPCABG with isoflurane preconditioning.
作者信息
Zhang Liang, Wang Cheng-Bin, Li Bo, Lin Duo-Mao, Ma Jun
机构信息
Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, No.2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, No.2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
出版信息
J Cardiothorac Surg. 2019 Jan 25;14(1):22. doi: 10.1186/s13019-019-0835-9.
BACKGROUND
Grafting vessel with LIMA to the left anterior descending coronary artery plays a most important role in the long-term prognosis of OPCABG surgery. The aim of this study was to compare the effects of isoflurane preconditioning on miRs and mRNAs levels in the left internal mammary arterie (LIMA) graft with propofol in patients undergoing off-pump coronary artery bypass surgery (OPCABG).
METHODS
Patients were randomly assigned to receive either propofol (n = 15), or interrupted isoflurane (n = 15). In group P, propofol administration was continued at 3-5 mg/kg/h intravenous injection for the duration of surgery. Five minutes prior to incision, patients of the isoflurane group (group Iso) received 2 cycles of 1 MAC isoflurane.
RESULTS
miR-221 were significantly lower in group Iso (P < 0 .05). E-selectin mRNA, RhoA mRNA and ROK mRNA were significantly lower at specimens of LIMA in group Iso compared with those in group P patients (P < 0 .05). The expression of NOS3 mRNA was significantly higher in group Iso patients (P < 0 .05).
CONCLUSION
Our findings provide some insight that prior interrupted isoflurane administration could regulate miR-221, and downstream effectors (mRNAs) and resulted in actual attenuation of inflammation and spasm of LIMA in patients undergoing OPCABG surgery.
TRIAL REGISTRATION
NCT No. ( ClinicalTrials.gov ): NCT02678650; Registration date: January 23, 2016.
背景
在非体外循环冠状动脉搭桥术（OPCABG）中，使用左乳内动脉（LIMA）移植血管至左前降支冠状动脉对长期预后起着至关重要的作用。本研究旨在比较异氟醚预处理与丙泊酚对非体外循环冠状动脉搭桥术（OPCABG）患者左乳内动脉（LIMA）移植物中微小RNA（miR）和信使核糖核酸（mRNA）水平的影响。
方法
患者被随机分配接受丙泊酚（n = 15）或间断异氟醚（n = 15）。在P组，手术期间以3 - 5mg/kg/h静脉注射持续给予丙泊酚。在切开前5分钟，异氟醚组（Iso组）患者接受2个周期的1个最低肺泡有效浓度（MAC）异氟醚。
结果
Iso组中miR - 221显著降低（P < 0.05）。与P组患者相比，Iso组LIMA标本中E - 选择素mRNA、RhoA mRNA和ROK mRNA显著降低（P < 0.05）。Iso组患者中NOS3 mRNA的表达显著升高（P < 0.05）。
结论
我们的研究结果提供了一些见解，即预先间断给予异氟醚可调节miR - 221及其下游效应物（mRNA），并实际减轻非体外循环冠状动脉搭桥术（OPCABG）患者LIMA的炎症和痉挛。
试验注册
（ClinicalTrials.gov）NCT编号：NCT02678650；注册日期：2016年1月23日。
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