炎症和外科手术期间心血管事件
Peter Poredos1,2, Radko Komadina3
1Department of Anaesthesiology and Surgical Intensive Care, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia.
Cells
|September 13, 2025
概括
手术会引发压力反应,增加炎症和心脏风险. 监测炎症生物标志物和管理炎症可以改善患者的治疗结果,减少外科手术期间的心脏事件.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 免疫学 免疫学 免疫学
背景情况:
- 手术和麻醉诱导应激反应,导致交感刺激,皮质醇分泌,高凝固性和全身炎症.
- 这些平静性变化,特别是系统性炎症,增加了器官损伤和术后心脏并发症的风险,影响了心血管和非心脏手术.
- 术前炎症标志物与术后心血管事件有关,突出显示了炎症在手术风险中的作用.
研究的目的:
- 探索系统性炎症在外科手术期间心脏并发症中的作用.
- 确定炎症生物标志物在预测心血管事件中的有用性.
- 讨论减少外科手术期间炎症反应和改善外科手术结果的策略.
主要方法:
- 对手术应激反应和炎症的当代文献的综述.
- 对传统生物标志物 (CRP,BNP) 和新生物标志物 (黄素-3,TNF-α,MiRNAs) 进行分析,以预测炎症反应和心脏损伤.
- 讨论在外科手术期间预防和治疗系统性炎症的方法.
主要成果:
- 外科手术可以引发全身炎症,其特点是有炎性细胞因子分泌,中性粒细胞激活和组织损伤.
- 炎症生物标志物,包括新的生物标志物,如 galectin-3 和 MiRNAs,可以预测外科手术期间的心脏损伤和心血管事件.
- 炎症标志物在手术后增加,通常在几周内下降,但手术前水平升高是显著的预测因素.
结论:
- 在外科手术期间确定炎症标志物可以识别心血管事件的高风险患者.
- 减少外科手术期间的炎症反应对于改善外科手术结果至关重要.
- 优化手术和麻醉管理,以及药理干预措施,如白蛋白抑制剂,可以减轻系统性炎症和增强外科手术期间的心脏风险降低策略.
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