[心脏外科手术中的全身炎症反应:使用胆固醇的可能性]
M L Diakova1, V M Shipulin1, Y S Svirko1
1Research Institute of Cardiology, Branch of the Tomsk National Research Medical Center of the Russian Academy of Sciences.
Kardiologiia
|July 31, 2023
概括
冠状动脉旁路移植 (CABG) 后与体外循环 (EC) 进行的素治疗可能会减少系统性炎症反应 (SIR) 的表现. 这种治疗显示出减少多发性肺炎和心律失常的趋势,对矩阵金属蛋白酶产生有希望的效果.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 冠状动脉旁路移植 (CABG) 与体外循环 (EC) 经常引发全身炎症反应 (SIR).
- 了解和缓解SIR对于改善心脏手术后患者的治疗结果至关重要.
- 接受CABG的缺血性心脏病 (IHD) 患者特别容易受到炎症并发症的影响.
研究的目的:
- 为了评估SIR的表现,在接受CABG和EC的患者中.
- 评估胆固醇治疗在降低CABG后SIR严重性的有效性.
- 调查菌素对炎症标志物和临床结果的影响.
主要方法:
- 一项涉及100名稳定IHD患者的研究,预计将与EC进行CABG.
- 第1组 (n=50) 接受了胆固醇 (手术前500微克,然后在手术后10天内两次服用500微克).
- 第二组 (n=50) 接受了非类固醇抗炎药物的标准护理;测量了炎症标志物 (细胞因子,MMP,新素).
主要成果:
- 胆固醇组显示出一种趋势,即肺炎和心房动 (AF) 的发病率较低.
- 在两组中都观察到手术后IL-10和IL-6的水平增加,而在菌素组中持续存在IL-10.
- 与对照组相比,素治疗导致CABG后3天的MMP-9水平降低.
结论:
- 含EC的CABG激活SIR;素治疗似乎可以减轻SIR的表现.
- 科尔奇辛在没有严重不良事件的情况下表现出降低流炎和心律失常等临床并发症的趋势.
- 胆固醇对矩阵金属蛋白酶的作用表明,在IHD患者中预防慢性心力衰竭进展和心肌重塑的潜在益处.
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