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冠状动脉搭桥手术患者心包液和血浆中的硫醇/二硫键稳态

Thiol/Disulfide Homeostasis in Pericardial Fluid and Plasma of Patients Undergoing Coronary Artery Bypass Surgery.

作者信息

Dikme Reşat, Taşkin Abdullah

机构信息

Department of Medical Biology and Genetics, Vocational School of Health Services, Harran University, Şanlıurfa, Turkey.

Department of Nutrition and Dietetics, Faculty of Health Sciences, Harran University, Şanlıurfa, Turkey.

出版信息

Braz J Cardiovasc Surg. 2025 Feb 24;40(1):e20220367. doi: 10.21470/1678-9741-2022-0367.

Abstract

INTRODUCTION

On-pump coronary artery bypass grafting (CABG) method affect almost allbiochemicalreactions by disrupting the patient's redox homeostasis. Detection of systemic redox hemostasis in the patient is critical for the CABG method's success and the prognosis of the disease. In this study, thiol/disulfide parameters, which are indicators of redox homeostasis, and ischemia-modified albumin levels in the plasma and pericardial fluid of patients who underwent CABG were investigated.

METHODS

Sixty patients who underwent an on-pump CABG operation with the cardiopulmonary bypass method were included in this study. Blood samples were taken from the patients before and after cardiopulmonary bypass. Pericardia fluid samples were taken before cardiopulmonary bypass. Then, thiol/disulfide homeostasis, albumin, and ischemia-modified albumin levels in the pericardial fluid and the patients' plasma levels were compared.

RESULTS

Albumin and ischemia-modified albumin levels were significantly higher in the postoperative period compared to the preoperative one (P<0.001). Thiol/disulfide parameters were higher and statistically significant in preoperative than in postoperative examinations (P<0.001). A negative correlation was found between pericardial fluid ischemia-modified albumin and thiol-disulfide parameters (P<0.001).

CONCLUSION

Changes in thiol/disulfide homeostasis, albumin, and ischemia-modified albumin levels at different times during the on-pump CABG may be caused by foreign non-endothelial surfaces, filters, the reperfusion process, and pharmacological effects in the extracorporeal circulation. Thiol/disulfide homeostasis, albumin, and ischemia-modified albumin levels should be monitored during the on-pump CABG and should be intervened with appropriate therapeutic strategies. In this way, secondary pathologies can be avoided by preventing cellular damage and excessive inflammatory responses.

摘要

引言

体外循环冠状动脉搭桥术(CABG)通过破坏患者的氧化还原稳态,几乎影响了所有生化反应。检测患者体内的全身氧化还原稳态对于CABG手术的成功及疾病预后至关重要。在本研究中,对接受CABG手术患者血浆和心包液中作为氧化还原稳态指标的硫醇/二硫键参数以及缺血修饰白蛋白水平进行了研究。

方法

本研究纳入了60例行体外循环CABG手术的患者。在体外循环前后采集患者血样。在体外循环前采集心包液样本。然后,比较心包液和患者血浆中硫醇/二硫键稳态、白蛋白及缺血修饰白蛋白水平。

结果

术后白蛋白和缺血修饰白蛋白水平显著高于术前(P<0.001)。术前硫醇/二硫键参数高于术后检查,且具有统计学意义(P<0.001)。心包液缺血修饰白蛋白与硫醇 - 二硫键参数之间呈负相关(P<0.001)。

结论

体外循环CABG过程中不同时间点硫醇/二硫键稳态、白蛋白及缺血修饰白蛋白水平的变化可能是由体外循环中的外来非内皮表面、滤器、再灌注过程及药理作用引起的。在体外循环CABG期间应监测硫醇/二硫键稳态、白蛋白及缺血修饰白蛋白水平,并应采用适当的治疗策略进行干预。通过这种方式,可通过预防细胞损伤和过度炎症反应来避免继发性病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9ed/11844310/9bf8cf4bfc6d/bjcvs-40-01-e20220367-g01.jpg

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