Sanrı Umut Serhat, Özsin Kadir Kaan, Toktaş Faruk, Balcı Abdullah Burak, Üstündağ Yasemin, Huysal Kağan, Erel Özcan, Yavuz Şenol
Department of Cardiovascular Surgery, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Clinical Laboratory, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Oct 23;27(4):484-492. doi: 10.5606/tgkdc.dergisi.2019.18033. eCollection 2019 Oct.
In this study, we aimed to investigate the effects of thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting.
Between January 2018 and October 2018, a total of 51 patients (43 males, 8 females; mean age 61.8±8.7 years; range, 38 to 78 years) who underwent isolated on-pump coronary artery bypass grafting were included. Thiol-disulfide homeostasis parameters were studied in the preoperative period (T1), 30 min after the removal of cross-clamp (T2), and postoperative sixth h (T3). Hemodynamic parameters such as atrial fibrillation and inotropic support requirement of the patients were evaluated in the postoperative period.
There were significant differences in the measured thiol-disulfide homeostasis parameters at different time points of surgery (p<0.001). Binary logistic regression analysis showed that T2-disulfide/native thiol ratio was an independent predictor of the development of postoperative atrial fibrillation (p=0.042). There were positive and significant correlations between the T2-disulfide levels and cross-clamp time (r:0.307, p=0.029).
Thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting changes toward to disulfide. Disulfide levels increase in parallel with prolonged ischemia time. Decreased native thiol and increased disulfide levels during ischemic period may be predictive of postoperative atrial fibrillation.
在本研究中,我们旨在调查体外循环冠状动脉旁路移植术患者中硫醇 - 二硫键稳态的影响。
纳入2018年1月至2018年10月期间共51例行单纯体外循环冠状动脉旁路移植术的患者(43例男性,8例女性;平均年龄61.8±8.7岁;范围38至78岁)。在术前阶段(T1)、松开主动脉阻断钳后30分钟(T2)和术后第6小时(T3)研究硫醇 - 二硫键稳态参数。在术后阶段评估患者的血流动力学参数,如房颤和对血管活性药物支持的需求。
手术不同时间点测得的硫醇 - 二硫键稳态参数存在显著差异(p<0.001)。二元逻辑回归分析表明,T2期二硫键/天然硫醇比值是术后房颤发生的独立预测因素(p = 0.042)。T2期二硫键水平与主动脉阻断时间呈正相关且具有统计学意义(r:0.307,p = 0.029)。
体外循环冠状动脉旁路移植术患者的硫醇 - 二硫键稳态向二硫键方向变化。二硫键水平随着缺血时间延长而升高。缺血期天然硫醇减少和二硫键水平升高可能预测术后房颤。