中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2008年
4期
342-345
,共4页
杨静%杨大烜%叶珏%张毅%李立环
楊靜%楊大烜%葉玨%張毅%李立環
양정%양대훤%협각%장의%리립배
腺苷%肿瘤坏死因子α%细胞粘附分子%冠状动脉旁路移植术,非体外循环%缺血预处理
腺苷%腫瘤壞死因子α%細胞粘附分子%冠狀動脈徬路移植術,非體外循環%缺血預處理
선감%종류배사인자α%세포점부분자%관상동맥방로이식술,비체외순배%결혈예처리
Adenosine%Tumor necrosis factor-alpha%Cell adhesion molecules%Coronary artery bypass,off-pump%Ischemic preconditioning
目的 探讨腺苷预处理对非体外循环冠状动脉旁路移植术(OPCABG)患者心肌肿瘤坏死因子-α(TNF-α)mRNA和细胞问黏附分子-1(ICAM-1)mRNA表达的影响.方法 择期初次行OPCABG患者40例,年龄44～68岁,随机分为2组(n=20):对照组和腺苷组.腺苷组于冠状动脉吻合前15 min经颈内静脉输注腺苷50 μg·kg-1·min-1,1 min后上调至100 μg·kg-1·min-1,2 min后上调至150μg·ks-1·min-1,输注7 min.输注结束后5 min开始冠状动脉吻合,对照组给予生理盐水.连续监测血液动力学参数.于腺苷预处理前(基础状态)和恢复血流15 min时,取右心耳组织约0.5 g,RT-PCR相对定量法测定心肌TNF-α mRNA和ICAM-1 mRNA的表达,透射电镜观察心肌超微结构.结果 与对照组比较,腺苷组心肌TNF-α mRNA和ICAM-1mRNA表达下调(P＜0.05),心肌病理损伤减轻.结论 腺苷预处理可通过下调OPCABG患者心肌TNF-α mRNA和ICAM-1mRNA表达,从而减轻心肌损伤.
目的 探討腺苷預處理對非體外循環冠狀動脈徬路移植術(OPCABG)患者心肌腫瘤壞死因子-α(TNF-α)mRNA和細胞問黏附分子-1(ICAM-1)mRNA錶達的影響.方法 擇期初次行OPCABG患者40例,年齡44～68歲,隨機分為2組(n=20):對照組和腺苷組.腺苷組于冠狀動脈吻閤前15 min經頸內靜脈輸註腺苷50 μg·kg-1·min-1,1 min後上調至100 μg·kg-1·min-1,2 min後上調至150μg·ks-1·min-1,輸註7 min.輸註結束後5 min開始冠狀動脈吻閤,對照組給予生理鹽水.連續鑑測血液動力學參數.于腺苷預處理前(基礎狀態)和恢複血流15 min時,取右心耳組織約0.5 g,RT-PCR相對定量法測定心肌TNF-α mRNA和ICAM-1 mRNA的錶達,透射電鏡觀察心肌超微結構.結果 與對照組比較,腺苷組心肌TNF-α mRNA和ICAM-1mRNA錶達下調(P＜0.05),心肌病理損傷減輕.結論 腺苷預處理可通過下調OPCABG患者心肌TNF-α mRNA和ICAM-1mRNA錶達,從而減輕心肌損傷.
목적 탐토선감예처리대비체외순배관상동맥방로이식술(OPCABG)환자심기종류배사인자-α(TNF-α)mRNA화세포문점부분자-1(ICAM-1)mRNA표체적영향.방법 택기초차행OPCABG환자40례,년령44～68세,수궤분위2조(n=20):대조조화선감조.선감조우관상동맥문합전15 min경경내정맥수주선감50 μg·kg-1·min-1,1 min후상조지100 μg·kg-1·min-1,2 min후상조지150μg·ks-1·min-1,수주7 min.수주결속후5 min개시관상동맥문합,대조조급여생리염수.련속감측혈액동역학삼수.우선감예처리전(기출상태)화회복혈류15 min시,취우심이조직약0.5 g,RT-PCR상대정량법측정심기TNF-α mRNA화ICAM-1 mRNA적표체,투사전경관찰심기초미결구.결과 여대조조비교,선감조심기TNF-α mRNA화ICAM-1mRNA표체하조(P＜0.05),심기병리손상감경.결론 선감예처리가통과하조OPCABG환자심기TNF-α mRNA화ICAM-1mRNA표체,종이감경심기손상.
Objective To investigate the effects of adenosine preconditioning on the expression of myocardial TNF-α mRNA and ICAM-1 mRNA in patients undergoing off-pump coronary artery bypass graft(OPCABG).Methods Forty patients,aged 44-68 yr,with more than three coronary artery obstructions and ejection fraction≥40%,undergoing elective OPCABG,were randomly divided into 2 groups(n=20 each):control group and ADO group.ADO group received adenosine preconditioning,the initial infusion rate was 50 μg·kg-1·min-1,then increased to 100 μg·kg-1·min-1 after 1 min,increased to 150 μg·kg-1·min-1 after 2 min and maintaining for 7 min.The vascular anastomosis was started at 5 min after preconditioning.While the control group received normal saline instead of adenosine.Tissue samples of the right auricle were taken before preconditioning(baseline)and at 15 min after blood current return to measure the expression of myocardial TNF-α mRNA and ICAM-1 mRNA and the myocardial ultrastructure was observed.Hemodyuamic permnetem were monitored.Results The myocardial damage was milder in ADO group than in control group.The expression of myocardial TNF-α mRNA and ICAM-1 mRNA Was significantly lower in ADO group than in contTol group(P＜0.05).Conclusion Adenosine preconditioning can attenuate myocardium ischemia-reperfusion injury in patients undergoing OPCABG through down-regulating the expression of myocardial TNF-α mRNA and ICAM-1 mRNA.
