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体外循环下冠状动脉搭桥术患者不同形式纤连蛋白的变化——一项前瞻性观察研究

Changes in various forms of fibronectin in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass - a prospective, observational study.

作者信息

Lemańska-Perek Anna, Krzyżanowska-Gołąb Dorota, Wysoczański Grzegorz, Barteczko-Grajek Barbara, Goździk Waldemar, Adamik Barbara

机构信息

Department of Chemistry and Immunochemistry, Wroclaw Medical University, M. Sklodowskiej-Curie 48/50, 50-369, Wroclaw, Poland.

University Clinical Hospital, ul. Borowska 213, 50-556, Wrocław, Poland.

出版信息

Sci Rep. 2024 Dec 28;14(1):30790. doi: 10.1038/s41598-024-80765-9.

Abstract

Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) is associated with the transient activation of a systemic inflammatory response. Fibronectin (FN), an endogenous inflammatory mediator, is a key component of the extracellular matrix. This study aimed to detect changes in cellular and plasma FN levels, as well as its potential fragmentation or FN-fibrin complex formation, in 40 patients undergoing CABG with CPB. Our results indicate that CPB was associated with changes in the levels of cellular and plasma FN and with intensified FN fragmentation. Moreover, FN-fibrin complexes were detected in all patients, indicating activation of the coagulation process during CPB. In a multivariate regression analysis, a history of arterial hypertension and CPB duration influenced plasma FN levels at 6 h (β = -0.458, p = 0.001; -0.375, p = 0.008, respectively) and 12 h (β = -0.293, p = 0.026; -0.554, p = 0.000) after surgery. Alterations in FN concentration, intensified FN degradation, and the presence of FN-fibrin complexes after surgery may suggest that these changes are related to the remodelling of the extracellular matrix resulting from cardiac surgery and the associated repair processes. The results indicate that FN has clinical potential as a marker of repair processes.

摘要

体外循环冠状动脉搭桥术(CABG)与全身炎症反应的短暂激活有关。纤连蛋白(FN)作为一种内源性炎症介质,是细胞外基质的关键组成部分。本研究旨在检测40例行体外循环CABG患者的细胞和血浆FN水平变化,以及其潜在的片段化或FN-纤维蛋白复合物形成情况。我们的结果表明,体外循环与细胞和血浆FN水平的变化以及FN片段化加剧有关。此外,在所有患者中均检测到FN-纤维蛋白复合物,表明体外循环期间凝血过程被激活。在多因素回归分析中,高血压病史和体外循环持续时间分别影响术后6小时(β = -0.458,p = 0.001;-0.375,p = 0.008)和12小时(β = -0.293,p = 0.026;-0.554,p = 0.000)的血浆FN水平。术后FN浓度的改变、FN降解加剧以及FN-纤维蛋白复合物的存在可能表明这些变化与心脏手术及相关修复过程导致的细胞外基质重塑有关。结果表明,FN作为修复过程的标志物具有临床应用潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7165/11681034/53cc328d5daa/41598_2024_80765_Fig1_HTML.jpg

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