CAJ | 학술논문

目的:探讨非体外循环冠状动脉旁路移植术(OPCABG)患者外周血中心肌营养素-1(CT-1)与脑钠尿肽(BNP)在围手术期及术后长期的浓度变化情况,及其在心脏外科的临床应用价值.方法:50例择期OPCABG患者,分别于术前、术后6 h、72 h及1周取外周静脉血测定CT-1、BNP浓度,术后10个月随访时再次检测,并记录患者心功能指标.结果:(1)CT-1浓度在围手术期无明显变化,术后10个月较其术前基础值升高.(2)BNP浓度术后6 h即有上升,72 h达峰值,并维持至术后1周,术后10个月恢复至术前水平.(3)术前CT-1、BNP浓度均与NYHA分级、左室舒张末期直径(LVEDD)呈正相关;与左室射血分数(LVEF)呈负相关.术后10个月CT-1、BNP浓度与NYHA分级、LVEDD、LVEF无线性相关性. 结论:OPCABG可引起外周血CT-1与BNP表达升高,但CT-1较BNP反应更缓慢和持久.在心脏外科CT-1、BNP血浆浓度术前可指导心功能评价,但其术后长期观察的临床意义尚需进一步研究.
목적:탐토비체외순배관상동맥방로이식술(OPCABG)환자외주혈중심기영양소-1(CT-1)여뇌납뇨태(BNP)재위수술기급술후장기적농도변화정황,급기재심장외과적림상응용개치.방법:50례택기OPCABG환자,분별우술전、술후6 h、72 h급1주취외주정맥혈측정CT-1、BNP농도,술후10개월수방시재차검측,병기록환자심공능지표.결과:(1)CT-1농도재위수술기무명현변화,술후10개월교기술전기출치승고.(2)BNP농도술후6 h즉유상승,72 h체봉치,병유지지술후1주,술후10개월회복지술전수평.(3)술전CT-1、BNP농도균여NYHA분급、좌실서장말기직경(LVEDD)정정상관;여좌실사혈분수(LVEF)정부상관.술후10개월CT-1、BNP농도여NYHA분급、LVEDD、LVEF무선성상관성. 결론:OPCABG가인기외주혈CT-1여BNP표체승고,단CT-1교BNP반응경완만화지구.재심장외과CT-1、BNP혈장농도술전가지도심공능평개,단기술후장기관찰적림상의의상수진일보연구.
Objective: To investigate the changes of peripheral cardiotrophin-1 (CT-1) and brain natriuretic peptide (BNP) concentrations in patients undergoing off-pump coronary artery bypass grafting (OPCABC), and the clinical significance of peripheral CT-1 and BNP in cardiac surgery thereof. Methods:Fifty elective OPCABG patients were included in the study. The concentrations of CT-l and BNP were measured before surgery, and at 6 hours, 72 hours, 1 week and 10 months after the operation respectively. The clinical data of the heart function were also collected in patients . Results:(1 )The peripheral CT-1 levels were significantly higher at 10 months after OPCABC than those before operation. (2 )The concentration of peripheral BNP increased at 6 hours after operation. The peak level was found at 72 hours, and remained higher level until the 1 week after operation. The BNP concentration was returned to the normal level at 10 months after OPCABG. (3 )The baseline levels of CT-1 and BNP were both positively correlated with NYHA rank and the diameter of the left ventricular end-diastolic dimension (LVEED), but negatively correlated with left ventricular ejection fraction (LVEF). However, no correlations were found between CT-1 and BNP and NYHA rank, LVEF or LVEED at 10 months after OPCAB. Conclusion:The perioperative blood BNP levels were increased significantly by OPCABG, while perioperative level of CT-1 increased slowly compared with that of BNP. In cardiac surgery,perioperative concentrations of CT-1 and BNP may reflect the cardiac function in patients before OPCABG. The further studies are warranted to assess the prognosis.