摘要
目的探讨体外循环和非体外循环下冠状动脉旁路移植术式对老年患者手术后血浆肾上腺髓质素（ADM）及内皮素-1（ET-1）的影响。方法选择体外循环和非体外循环冠状动脉旁路移植术老年患者各20例，于术前、术后即刻、术后6h、24h和术后3d抽取静脉血，采用放射免疫法测定血浆ADM及ET-1的浓度。结果体外组和非体外组患者术后即刻ET-1及ADM浓度均明显升高，ET-1分别为（67．59±10．18）ng／L和（58．73±9．64）ng／L，ADM分别为（284．90±36．24）ng／L和（243．25±25．70）ng／L，且体外组升高更明显（P〈0．05）；体外组和非体外组术后6hET-1及ADM浓度开始下降，并延续至24h后，术后3d非体外组基本恢复至术前水平，体外组尚处于较高水平。结论体外循环和非体外循环冠状动脉旁路移植术均可引起血管内皮功能紊乱，导致血浆ET-1及ADM水平升高，但非体外循环冠状动脉旁路移植术对其影响较小。
Objective To investigate the effects of on pump and off-pump coronary artery bypass grafting on plasma adrenomedullin （ADM） and endothelin-1 （ET-1） levels before and after operation in elderly patients. Methods Elderly patients aged 60 years and over with coronary artery bypass grafting were enrolled in the study and divided into off pump group and on-pump group, each group had 20 cases. Blood samples were collected before surgery, immediately after operation and 6, 24 hours, 3 days after operation. The plasma levels of ADM and ET 1 were decteeded by radio immunoassay. Results The levels of ADM and ET-1 were significantly increased immediately after operation in 2 groups of on-and off-pump. The levels of ET-1 in on-pump group and off-pump group were （67.59±10. 18） ng/L and （58. 73±9.64） ng/L respectively. The levels of ADM in on-and off- groups were （284.90 ± 36.24） ng/L and （243.25 ± 25.70） ng/L. This showed that in on-pump group, the plasma levels of ADM and ET-1 increased more significantly（P〈0. 05）. The plasma levels of ADM and ET-1 began to decline at 6 hours after operation, and continued to 24 hours after operation. On 3 days after operation, the plasma levels of ADM and ET-1 in off-pump group returned to the preoperative level, but they were still maintained at a high level in on-pump group. Conclusions For elderly patients, both on-pump and off-pump coronary artery bypass grafting can cause endothelial dysfunction, increasing plasma levels of ET 1 and ADM. But compared with the on- pump coronary artery bypass grafting, the off-pump coronary artery bypass grafting has less influence.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2008年第5期325-326,共2页
Chinese Journal of Geriatrics
