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外科研究与新技术（中英文）

外科研究与新技术 ›› 2018, Vol. 7 ›› Issue (3): 153-156.doi: 10.3969/j.issn.2095-378X.2018.03.001

• 论著 •    下一篇

乌司他丁对不停跳冠状动脉搭桥术后低氧血症患者炎症因子和心肺功能的影响

王飞, 黄海涛, 沈亮, 陆晨希, 仲崇俊   

  1. 南通大学第二附属医院胸心外科,南通 226001
  • 收稿日期:2018-08-09 出版日期:2018-09-28 发布日期:2019-12-16
  • 通讯作者: 仲崇俊,主任医师,电子信箱:zhongcjnt@sina.com
  • 作者简介:王 飞(1982—),女,江苏省南通市,硕士,主治医师,心脏外科术后监护

Effect of ulinastatin on inflammatory cytokines and cardiopulmonary function in hypoxemia patients after off-pump CABG

WANG Fei, HUANG Haitao, SHEN Liang, LU Chenxi, ZHONG Chongjun   

  1. Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nantong University, Nantong 226001, China
  • Received:2018-08-09 Online:2018-09-28 Published:2019-12-16

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摘要： 目的 乌司他丁对不停跳冠状动脉(冠脉)搭桥术后低氧血症患者炎症因子及心肺功能影响的临床研究。方法 40例不停跳冠脉搭桥术后出现低氧血症的患者随机分成对照组(20例)和实验组(20例),对照组采用常规治疗,实验组在常规治疗的基础上加上乌司他丁治疗。分别在治疗前(T0),治疗后4 h(T1)、24 h(T2)、48 h(T3)、72 h(T4)抽取患者动脉血,测定氧分压(PaO2)、脑钠肽(BNP)、肌钙蛋白I(cTnI)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、IL-8;分别记录患者的吸入气氧浓度(FiO2)、心率(HR)、平均动脉压(MBP);观察ICU滞留时间及气管插管时间。采用SPSS 19.0软件对数据进行统计学分析。 结果 治疗前实验组和对照组一般资料差异和治疗前无统计学意义(P>0.05),两组在治疗后的血压和心率差异无统计学意义(P＞0.05),实验组的氧合指数(OI,PaO2/FiO2)在治疗后较对照组有改善(P<0.05),实验组的IL-6、IL-8、TNF-α,BNP水平较对照组下降(P<0.05),实验组和对照组在术后早期4 h肌钙蛋白I无显著差异(P＞0.05),但在24、48、72 h,实验组较对照组下降(P<0.05),气管插管时间和ICU滞留时间低于对照组(P<0.05)。结论 乌司他丁可降低不停跳冠脉搭桥术后低氧患者炎症反应,改善患者术后心肺功能,并可缩短冠脉搭桥患者术后气管插管时间及ICU滞留时间。

关键词: 乌司他丁, 冠脉搭桥术, 炎症因子, 低氧血症

Abstract: Objective To investigate the effect of ulinastatin on inflammatory cytokines and cardiopulmonary function in hypoxemia patients after off-pump coronary artery bypass graft (CABG).Methods Forty hypoxemia patients, who had off-pump CABG surgery, were randomly divided into two groups, control group (n=20) and observation group (n=20).Patients in both groups accepted routine treatment.The observation group was given the treatment of ulinastatin additionally.Fractional concentration of inspired oxygen (FiO2), heart rate (HR), mean arterial pressure (MBP), arterial oxygen partial pressure (PaO2), plasma tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, brain natriuretic peptide (BNP), and cardiac troponin I (cTnI) were observed at pre-treatment (T0), 4 hours after treatment (T1), 24 hours after treatment (T2), 48 hours after treatment (T3), and 72 hours after treatment (T4). Duration of ICU stay and endotracheal intubation time were also observed.Results The differences in general information between the two groups were not significant before treatment (P>0.05). The differences in HR and MBP were not significant (P＞0.05) between the two groups after treatment.Compared with the control group, OI was improved, while the serum IL-6, IL-8, IFN-α, and BNP levels all lower in the observation group after treatment (P＜0.05).There was no significant difference in cTnI at T1 between the two groups (P＞0.05), but cTnI was lower in the observation group than the control group at T2, T3, and T4 (P<0.05).Endotracheal intubation time and the duration of ICU stay of the observation group were much shorter than those of the control group (P＜0.05).Conclusion Ulinastatin treatment for hypoxemia after off-pump CABG could reduce inflammation response cardiopulmonary improve cardiopulmonary, and shorten endotracheal intubation and duration of ICU stay.

Key words: Ulinastatin, Coronary artery bypass graft, Inflammatory cytokines, Hypoxemia

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