结晶体与冷血相比心脏和心脏素我释放
Circulation
|July 1, 1997
概括
在冠状动脉旁路移植过程中,冷血性心脏与温暖的再注血提供了比晶体性心脏更好的心肌保护,这是较低的心脏素I (CTnI) 释放所表明的. 这种方法有助于诊断心肌损伤并减少除需求.
科学领域:
- 心血管外科心血管外科
- 心脏麻醉心脏麻醉
- 心肌损伤的生物标志物
背景情况:
- 心脏素I (CTnI) 是心肌损伤的公认生物标志物.
- 评估心肌保护策略在心脏手术中至关重要.
研究的目的:
- 为了比较前期结晶性心脏的疗效与前期冷血性心脏与热再注血的疗效.
- 利用CTnI释放作为评估心肌保护充分性的指标.
主要方法:
- 随机地将70名患者分配到结晶性心或血液心组.
- 在手术后长达5天的静脉血液样本中进行连续CTnI测量.
- 使用ANOVA和重复测量的统计分析来比较CTnI释放模式.
主要成果:
- 血型心症组的CTnI总释放量明显低于晶体质组的CTnI总释放量 (7.8比11.2μg,P<0.02).
- 在晶体组中,在手术后9小时和12小时观察到CTnI度升高.
- 在5名患者 (血液) 和8名患者 (晶体) 中发现了术前心肌梗塞的CTnI证据.
结论:
- 在选择性冠状动脉旁路移植患者中,冷血心脏与热再注血具有有益的作用,对心肌保护具有有益的作用,左心室功能得到保护.
- CTnI有效地识别了外科手术期间心肌缩的小区域.
- 较高的CTnI释放与大动脉解紧后需要进行电动除的相关性.
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