文章摘要
王常田,李德闽,申 翼,黄海嵘,苏 畅,景 华.冠状动脉旁路移植术中基质金属蛋白酶-9及炎症介质的释放及相关性[J].南京医科大学学报,2010,(12):1687~1690
冠状动脉旁路移植术中基质金属蛋白酶-9及炎症介质的释放及相关性
Release and correlation of matrix metalloproteinase-9 and inflammatory markers in patients undergoing coronary artery bypass grafting
投稿时间:2010-06-03  
DOI:10.7655
中文关键词: 冠状动脉旁路移植术  基质金属蛋白酶-9  炎症介质
英文关键词: coronary artery bypass grafting  matrix metalloproteinase-9  Inflammatory marker
基金项目:国家自然科学基金资助(30972969)
作者单位
王常田 第二军医大学临床学院 南京军区南京总医院心胸外科,江苏 南京 210002 
李德闽 第二军医大学临床学院 南京军区南京总医院心胸外科,江苏 南京 210002 
申 翼 第二军医大学临床学院 南京军区南京总医院心胸外科,江苏 南京 210002 
黄海嵘 第二军医大学临床学院 南京军区南京总医院心胸外科,江苏 南京 210002 
苏 畅 第二军医大学临床学院 南京军区南京总医院心胸外科,江苏 南京 210002 
景 华 第二军医大学临床学院 南京军区南京总医院心胸外科,江苏 南京 210002 
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中文摘要:
      目的: 探讨体外循环下冠状动脉旁路移植术(coronary artery bypass grafting,CABG)和非体外循环下冠状动脉旁路移植术(off-pump coronary artery bypass surgery,OPCAB)中血清基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)和炎症介质的变化规律?方法:选择择期CABG和OPCAB的患者各18例,CABG组在麻醉插管前(T0)?CPB开始后15 min(T1)?CPB结束时(T2)?CPB结束后2 h(T3)和6 h(T4)时间点采集动脉血标本,OPCAB在麻醉插管前(T0)?前降支吻合完成时(T1)?所有吻合完成时(T2)?吻合完成后2 h(T3)和6 h(T4)时间点采集动脉血标本,采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)测定血清MMP-9及炎症介质TNF-α和IL-8的含量?结果:CABG组MMP-9和TNF-α?IL-8的释放较OPCAB组明显升高(P < 0.01);CABG组MMP-9?TNF-α和IL-8在体外循环结束时达到最高峰值,与CPB前相比P < 0.01,之后呈下降趋势,而且MMP-9的升高与TNF-α和IL-8升高呈正相关(r值分别为0.72和0.56);OPCAB组中三者呈持续低水平上升?结论:体外循环过程可引起血清MMP-9释放增加,炎症介质TNF-α和IL-8可能对MMP-9的释放起诱导和放大作用,血清MMP-9释放可能参与体外循环术所致的全身炎症反应?
英文摘要:
      Objective: To assess the release and timing of matrix metalloproteinase-9(MMP-9)and inflammatory markers in patients taken coronary artery bypass grafting(CABG) with cardiopulmonary bypass(CPB) and off-pump coronary artery bypass surgery(OPCAB). Methods:Eighteen patients each subjected to coronary artery bypass grafting and off-pump coronary artery bypass surgery respectively were included in this study. In the CPB group,artery blood samples were collected for biochemical measurements at the following time points:immediately prior to the induction of anesthesia,15 min after initiation of CPB,termination of CPB,2 and 6 h after termination of CPB. In the OPCAB group,time points were as follows:T0,before induction of anesthesia;T1,after completion of anastomose of left anterior descending coronary atery;T2 after completion of all anastomoses;T3,at 2 h,T4,at 6 h after completion of all anastomoses. Results:The levels of MMP-9,TNF-α and IL-8 in CABG group were higher significant than in OPCAB group(P < 0.01). Concentration of MMP-9,TNF-α and IL-8 peaked at termination of CPB in CABG group(P < 0.01). The correlaton between MMP-9 and TNF-α,MMP-9 and IL-8 were significant(r,0.72 and 0.56,respectively). Conclusion:Cardiopulmonary bypass induced the release of MMP-9. TNF-α and IL-8 might amplify the release of MMP-9. The release of MMP-9 could contribute to the CPB-induced inflammatory reaction.
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