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乌司他丁对体外循环下心瓣膜置换术患者心肌缺血再灌注损伤、心功能及血清 TNF-α和 IL-10 水平的影响。

Effects of Ulinastatin on Myocardial Ischemia-Reperfusion Injury, Cardiac Function, and Serum TNF- and IL-10 Levels in Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass.

机构信息

Department of Cardiovascular Surgery, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu City, 241000 Anhui Province, China.

出版信息

Comput Math Methods Med. 2022 Apr 1;2022:1823398. doi: 10.1155/2022/1823398. eCollection 2022.

Abstract

BACKGROUND

Myocardial ischemia-reperfusion injury (MIRI) is a very common adverse reaction after cardiac valve replacement (CVR) under cardiopulmonary bypass, which seriously affects the rehabilitation and prognosis of patients.

OBJECTIVE

The prevention and treatment of MIRI are a hotspot of modern medical research, and this study is aimed at providing reliable reference and guidance for future clinical prevention and treatment of MIRI by analyzing the effects of ulinastatin (UL) on cardiac function and MIRI of patients after CVR.

METHODS

A total of 104 patients undergoing CVR under cardiopulmonary bypass in our hospital were selected as research participants. Among them, 52 patients treated with UL were assigned to the observation group, and the rest 52 patients given the same amount of normal saline were assigned to the control group. The cardiopulmonary bypass status, postoperative status, cardiac function, inflammatory response, oxidative stress response, and hemodynamics were observed and compared between the two groups. In addition, clinical efficacy and safety and patient prognosis were compared.

RESULTS

Through experimental analysis, we found that UL had no significant effect on the clinical efficacy, safety, and prognosis of patients after surgery ( > 0.05) but had obvious protective effects on cardiopulmonary bypass status, cardiac function, inflammation, oxidative stress, and hemodynamics ( < 0.05).

CONCLUSION

UL can effectively prevent the occurrence of MIRI after CVR under cardiopulmonary bypass, which is worthy of clinical application.

摘要

背景

心肌缺血再灌注损伤(MIRI)是体外循环下心瓣膜置换术(CVR)后非常常见的不良反应,严重影响患者的康复和预后。

目的

MIRI 的防治是现代医学研究的热点,本研究旨在通过分析乌司他丁(UL)对 CVR 后患者心功能和 MIRI 的影响,为今后临床防治 MIRI 提供可靠的参考和指导。

方法

选取我院行体外循环下 CVR 的 104 例患者作为研究对象,其中 UL 治疗的 52 例患者分为观察组,其余给予等量生理盐水的 52 例患者分为对照组。观察两组患者体外循环状态、术后状态、心功能、炎症反应、氧化应激反应和血流动力学情况,并进行比较。此外,还比较了两组的临床疗效和安全性以及患者预后。

结果

通过实验分析发现,UL 对患者术后的临床疗效、安全性和预后无明显影响(>0.05),但对体外循环状态、心功能、炎症、氧化应激和血流动力学有明显的保护作用(<0.05)。

结论

UL 能有效预防体外循环下心瓣膜置换术后 MIRI 的发生,值得临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ab7/8993558/69e8c72cd141/CMMM2022-1823398.001.jpg

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