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心血管手术中的冷反应蛋白

Cold Reactive Proteins in Cardiovascular Surgery.

作者信息

Panagiotopoulos Ioannis, Mulita Francesk, Verras Georgios-Ioannis, Katinioti Anastasia, Samaras Angelos, Tasios Konstantinos, Bouchagier Konstantinos, Triantafyllou Konstantinos

机构信息

Cardiac Surgery Department, University Hospital of Patras, Patras, Greece.

Surgical Department, University Hospital of Patras, Patras, Greece.

出版信息

Mater Sociomed. 2022 Dec;34(4):301. doi: 10.5455/msm.2022.34.301-304.

Abstract

BACKGROUND

According to the literature, Cryoglobins, Cold Agglutinins, Donath-Landsteiner antibodies, and Cryofibrinogen arethe 4 types of Cold-Reactive proteins described.

OBJECTIVE

The aim of the study was to show the role of these proteins cardiovascular surgery.

CASE PRESENTATION

A 57-year-old male patient with a history of myocardial infarction 6 years ago, heavy smoker until 1 year ago, with diabetes, was admitted to the hospital for a surgical confrontation of coronary disease. He reports that for1-month symptoms are deteriorating (NYHA III). The history of the patient does not include either hematopoietic system or connective tissue diseases or recent viral infection. Angiographic control showed total obstruction of the small branch. The patient underwent median sternotomy. Suspension of the left sternum. Mobilization of the left internal mammary artery. Concomitant reception of left great saphenous vein. Intubation of ascending aorta and right atrium - vena cava with acatheter of two steps. He was extubated at the 10th post-surgical hour. Smooth post-surgical progression, with no signs of brain, myocardial or renal failure. The patient was discharged on the 5th post-surgical day.

CONCLUSION

Independently of the technique that is used, the systemic temperature must be maintained duringthe cardiopulmonary bypass above the temperature threshold activity of the cold-reactiveproteins.

摘要

背景

根据文献记载,冷球蛋白、冷凝集素、多纳-兰德斯泰纳抗体和冷纤维蛋白原是所描述的4种冷反应蛋白类型。

目的

本研究的目的是展示这些蛋白在心血管外科手术中的作用。

病例介绍

一名57岁男性患者,6年前有心肌梗死病史,直到1年前一直重度吸烟,患有糖尿病,因冠心病手术入院。他报告说1个月来症状不断恶化(纽约心脏协会心功能分级III级)。患者既往史中不包括造血系统或结缔组织疾病或近期病毒感染。血管造影检查显示小分支完全阻塞。患者接受了正中胸骨切开术。左胸骨悬吊。左乳内动脉游离。同时取左大隐静脉。用两步导管对升主动脉和右心房-腔静脉进行插管。术后第10小时拔管。术后恢复顺利,无脑、心肌或肾衰竭迹象。患者于术后第5天出院。

结论

无论采用何种技术,在体外循环期间必须将体温维持在高于冷反应蛋白活性温度阈值之上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c647/10019872/c39b5b28deb0/MSM-34-301-g001.jpg

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