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クリスタロイド対冷血心筋麻痺と心臓のトロポニン I 放出

H Pichon¹, S Chocron, K Alwan

¹Department of Thoracic, Saint-Jacques Hospital, Besancon, France.

|July 1, 1997

まとめ

熱い再注射による冷血性心症は,冠動脈バイパス移植の際に結晶性心症よりも,心臓の下部トロポニンI (CTnI) の放出によって示されるよりよい心筋膜の保護を提供します. この方法は,心筋梗塞の損傷を診断し, défibrillation の必要性を減らすのに役立ちます.

科学分野:

心血管外科手術についてです.
心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,心臓麻酔 (Cardiac Anesthesia) とは,
心筋損傷のバイオマーカー

背景:

心臓トロポニンI (CTnI) は,心筋損傷の認識されたバイオマーカーです.
心臓外科手術において,心筋臓の保護戦略の評価は極めて重要です.

研究の目的:

前段階の結晶性心不全と,前段階の冷血性心不全と温熱再注血の効果を比較する.
CTnIの放出を心筋動脈の保護の十分性を評価する指標として利用する.

主な方法:

70人の患者をランダムに,結晶性または血液性心筋麻痺のグループに分けました.
手術後5日までの静脈血液サンプルにおける連続CTnI測定.
CTnI放出パターンを比較するために,繰り返し測定したANOVAを用いた統計分析.

主要な成果:

血中心症のグループは,結晶体群と比較して,CTnIの総放出量が著しく低下した (7.8対11.2μg,P < .02).
結晶体群では,処置後9時間および12時間後にCTnI濃度の上昇が観察されました.
術後の心筋梗塞のCTnI証拠は,5人の患者 (血液) と8人の患者 (結晶体) で発見されました.

結論:

暖かい再注射による前段階の冷血性心症は,選択性冠動脈バイパス移植で左心室機能が保たれている患者の心筋膜の保護に有益な効果を示しています.
CTnIは,手術後の心筋縮の小さな領域を効果的に特定します.
高度のCTnI放出は,大動脈解閉後の電気除細動の必要性と相関する.

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