高级检索

    环氧二十碳三烯酸、N端脑钠肽前体、肌钙蛋白与冠状动脉旁路移植术后早期并发症的关系研究

    Relationship between epoxyeicosatrienoic acid,N-terminal brain natriuretic peptide precursor and troponin in early complications after coronary artery bypass grafting

      摘要
    • 摘要: 目的：探讨环氧二十碳三烯酸(EET)、N端脑钠肽前体(NT-proBNP)、肌钙蛋白(cTnI)与冠状动脉旁路移植术(CABG)后早期并发症的关系。方法：选取全麻体外循环下行CABG病人作为研究对象,根据术后有无并发症分为并发症组(n=39)和无并发症组(n=66),记录病人术前EET、基础资料、术中体外循环时间、升主动脉阻断时间、移植血管数以及术后24、48、72 h的NT-proBNP、cTnI水平。结果：并发症组病人年龄、体质量指数均高于无并发症组(P<0.05),并发症组病人左心室射血分数、14,15-EET水平低于无并发症组(P<0.05),并发症组的体外循环时间、阻断时间和术后ICU停留时间均高于无并发症组(P<0.05)。2组血清NT-proBNP、cTnI水平在不同时间点差异均有统计学意义(P<0.01)；并发症组术后 24、48、72 h 的血清NT-proBNP、cTnI水平均高于无并发症组(P<0.01)。14,15-EET是体外循环下CABG发生术后并发症的危险因素(P<0.01)。14,15-EET 预测术后早期并发症发生AUC为0.772(95%CI：0.682~0.863),临界值为49.05 μg/L,灵敏度为78.8%,特异度为64.1%。24 h的cTnI水平与14,15-EET水平呈显著负相关关系(r=-0.253,P<0.05)。结论：CABG病人术前血清低EET水平与并发症发生有关,术前血清EET水平对术后早期并发症有预测价值,术后不同时间NT-proBNP、cTnI可以为病人的预后进行早期评估。

       

      Abstract: Objective: To investigate the relationship between epoxyeicosatrienoic acid (EET),N-terminal brain natriuretic peptide precursor (NT-proBNP) and troponin (cTnI) in the early complications after coronary artery bypass grafting (CABG). Methods: Patients undergoing CABG under general anesthesia with extracorporeal circulation were selected as study subjects and divided into complication group (n=39) and non-complication group (n=66) according to the presence or absence of postoperative complications,and patients' preoperative EET,basal data,intraoperative extracorporeal circulation time,ascending aortic block time,number of graft vessels,and NT-proBNP and cTnI levels at 24,48,and 72 h after operation were recorded. Results: The age and body mass index of patients in the complication group were higher than those in the non-complication group (P<0.05).The left ventricular ejection fraction,14,15-EET levels in the complication group were lower than those in the non-complication group (P<0.05).The extracorporeal circulation time,blocking time,and postoperative ICU stay time in the complication group were higher than those in the non-complication group (P<0.05).The levels of serum NT-proBNP and cTnI in the two groups showed statistical significance at different time points (P<0.01).The serum NT proBNP and cTnI levels in the complication group were higher than those in the non-complication group at 24,48,and 72 h after surgery (P<0.01).14,15-EET was a risk factor for postoperative complications of CABG under cardiopulmonary bypass (P<0.01).The AUC for predicting early postoperative complications using 14,15-EET was 0.772 (95%CI:0.682-0.863),with a critical value of 49.05 μg/L,sensitivity of 78.8%,and specificity of 64.1%.The 24-hour cTnI level showed a significant negative correlation with the levels of 14,15-EET (r=-0.253,P<0.05). Conclusions: Low preoperative serum EET levels in CABG patients are associated with the occurrence of complications,and preoperative serum EET levels have predictive value for early postoperative complications,and NT-proBNP and cTnI at different postoperative times can provide an early assessment of patient prognosis.

       

      • HTML全文
      • 参考文献(20)
      • 相关文章
      • 施引文献
    • 资源附件(0)

    /

    返回文章
    返回