摘要
目的 观察体外循环冠状动脉 (冠脉 )旁路移植术中吸烟患者血浆 15 F2 t isoprostane(15 F2 t Iso P)的变化及其与术后心功能恢复的关系。方法 选择 30例吸烟冠心病患者及 30例非吸烟冠心病患者 ,均在异丙酚、芬太尼复合麻醉及体外循环下行冠脉旁路移植术。分别于麻醉诱导后手术前 (T0 )、主动脉阻断后 30 m in(T1)、主动脉开放后 10 min(T2 )及 30 m in(T3)经中心静脉抽血 ,测血浆游离 15 F2 t Iso P浓度。结果 T0时吸烟及非吸烟组血浆 15 F2 t Iso P浓度差异无显著性。T1时两组血浆 15 F2 t Iso P显著升高 (与 T0比较 ,P均 <0 .0 1) ,此时吸烟组 15 F2 t Iso P的升高幅度显著高于非吸烟组 (P<0 .0 5 )。再灌注期 (T2、T3)吸烟组血浆 15 F2 t Iso P浓度下降速度较非吸烟组为慢 ,术后更多患者需血管活性药物支持。结论 吸烟者体内抗氧化能力降低 ,增加了心脏手术后心功能障碍的发生率。
Objective To investigate the change in plasma free 15F 2t isoprostane (15F 2t IsoP) concentration and its relationship with postoperative cardiac function of smoking patients who underwent coronary artery bypass grafting(CABG). Methods Sixty patients with coronary artery heart disease were divided into smoking group 〔 n =30, age 5469 years old, American Heart Association(AHA)ⅡⅢ〕 and nonsmoking group( n =30, age 5870 years old, ASA ⅡⅢ). All the patients were scheduled for CABG under combination anesthesia with isoflurane and fentanyl and conventional cardiopulmonary bypass. Blood samples were drawn from the central vein to measure 15F 2t IsoP at the following time points: before operation(T0) ; 30 minutes after aortic clamping for cardiopulmonary bypass(T1); 10 and 30 minutes after aortic declamping(T2,T3). Results There was no statistical difference in 15F 2t IsoP between two groups at T0, but contents of 15F 2t IsoP in the two groups was increased markedly at T1, compared to those at T0( P <0 05 and P <0 01 for smoking and nonsmoking groups, respectively), and the degree of increase of 15F 2t IsoP in smoking group was significantly higher than that in nonsmoking group( P <0 05). During reperfusion period (at T2,T3), the rate of lowering of 15F 2t IsoP in smoking group was slower than that in nonsmoking group( P <0 05), and moreover, these patients needed more inotropic support than those in nonsmoking group. Conclusion Smoking patients have weaker antioxidation capability during CABG, therefore they have higher incidence of low cardiac function.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2005年第3期165-167,共3页
Chinese Critical Care Medicine
基金
广东省深圳市科研基金重点资助项目 (2 0 0 3 0 4175 )
