高风险患者非体外循环冠状动脉旁路移植

目的 评价高风险患者非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCAB)的安全性、效果及术式的选择.方法 回顾分析2002年6月～2005年12月OPCAB术的临床资料,根据欧洲心脏手术风险评分模型(European system for cardiac operative risk evaluation,EuroSCORE)计算每一病例的风险分数,＞5分者作为高风险病例进入本研究,共113例,以同期行体外循环冠状动脉旁路移植(cardiopulmonary bypass coronary artery bypass grafting,CCAB)的76例高风险患者作为对照.分别统计两组的手术前风险因素,并对手术中情况、手术后结果进行统计分析对比.结果 两组EuroSORE分别为9.0±2.6和8.3±2.1(t=2.016,P=0.045).移植血管数OPCAB组(3.2±0.9)少于CCAB组(3.8±0.9)(t=-4.267,P=0.000).术后肌酸激酶、肌酸激酶同功酶OPCAB组[570(61～8246)U/L、20(1～282)U/L]显著低于CCAB组[870(246～8155)U/L、55(12～300)U/L](Z=-3.648、-5.767,P=0.000).输血量OPCAB组显著少于CCAB组[(775±693)ml vs(1088±712)ml,t=-2.887,P=0.004].术后并发症差异无显著性.死亡率OPCAB组3.5%(4/113),CCAB组6.6%(5/76),差异无显著性(χ2=0.925,P=0.336).结论 对于高风险病人采纳OPCAB的方法是安全的,临床效果满意.但对于有不同风险因素的病人应采用不同的手术方法.     

老年患者体外与非体外循环冠状动脉旁路移植术术后急性肾损伤的对比研究

目的对比研究老年患者(年龄≥70岁)体外循环冠状动脉旁路移植术(cardiopulmonary coronary artery bypass grafting,CCABG)和非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCAB)对术后急性肾损伤(acute kidney injury,AKI)发生的影响。方法回顾性分析我中心2009年1月1日至2017年12月31日接受单纯冠状动脉旁路移植术(coronary artery bypass grafting,CABG)的老年患者的临床资料。剔除术前接受肾脏替代治疗、肌酐值记录缺失、急诊手术及合并其他手术的病例。期间单纯行CABG患者共3 346例,其中老年患者(年龄≥70岁) 1 405例(42.0%),根据是否使用体外循环机将该组老年患者分为CCABG组(956例)和OPCAB组(449例)。比较两组术后AKI的发生率及严重程度。结果 CCABG组术后AKI共发生306例(32.0%),OPCAB组138例(30.7%),两组差异无统计意义(P=0.677)。依据急性肾损伤信息网(AKIN)分期进一步细分,CCABG组较OPCAB组分别如下:AKINⅠ期:211例(22.1%)/93例(20.7%);AKINⅡ期:51例(5.3%)/23例(5.1%);AKINⅢ期44例(4.6%)/22例(4.9%),两组差异无统计意义(P=0.579,1.000,0.788)。住院期间CCABG组新发肾功能衰竭需透析患者31例(3.2%),OPCAB组10例(2.2%),两组差异无统计意义(P=0.376)。结论老年CABG患者术后发生AKI常见,且以AKIⅠ期为主,术后新发肾功能衰竭需透析比例总体较低。OPCAB较CCABG,并不能显著降低老年CABG患者术后AKI的发生率及严重程度。     

常规与非体外循环下冠状动脉3支病变旁路移植血管通畅性对比分析

目的　评价非体外循环下冠状动脉旁路移植术 (OPCAB)与体外循环下冠状动脉旁路移植术 (CCABG)治疗冠状动脉三支病变术中旁路早期通畅性。方法　 6 0例 3支血管病变的病人分为OPCAB组和CCABG组 ,每组各 30例。行冠状动脉旁路移植术 ,OPCAB组胸骨正中切口 ,在非体外循环心脏不停跳下完成手术 ;CCABG组建立常规体外循环 ,心脏停跳下完成手术。术中应用即时血流测量技术对旁路血管进行流量测量。对比分析两组术前、术后的各项指标及各血管旁路流量、搏动指数和血流波形。结果　两组病人术前一般情况差异无统计学意义。OPCAB组与CCABG组移植旁路血管分别为 (3 6±0 6 )支与 (4 3± 0 9)支 (P <0 0 1) ;两组前降支及右冠状动脉旁路血流量、搏动指数差异无显著性。CCABG组回旋支序贯旁路和远端吻合口多 ,血流量较OPCAB组高。两组弥漫病变血管旁路血流量小。结论　OPCAB与CCABG治疗 3支病变 ,两组血管旁路早期通畅性差异无显著性。     

体外循环与非体外循环下冠状动脉旁路移植术移植血管流量对比分析

目的比较非体外循环下冠状动脉旁路移植术(off-pump coronary artery bypass graft,OPCABG)与传统体外循环下冠状动脉旁路移植术(conventional on-pump coronary artery bypass graft,CCABG)移植血管通畅性。方法利用瞬时血流测定技术(transit-time flow meter,TTFM)对105例CCABG和140例OPCABG移植血管进行测量,并记录平均流量(mean flow,Qm)及搏动指数(pulsatility index,PI)。结果2组一般情况无显著性差异,2组旁路移植血管数目及血管材料无差异。流量测定结果,乳内动脉OPCABG组(n=101)Qm(37.2±26.6)ml/min,PI3.3±1.3;CCABG组(n=75)Qm(39.5±21.8)ml/min,PI3.3±1.2,两组差异无显著性(t=-0.612、0.000,P>0.05),大隐静脉流量两组也无显著性差异[OPCABG组(n=335)Qm(36.8±27.4)ml/min,PI3.1±1.5;CCABG组(n=281)Qm(40.9±...     

70岁以上病人非体外循环与常规冠状动脉旁路移植术比较

目的　探讨 70岁以上老年病人非体外循环冠状动脉旁路移植术 (OPCAB)的疗效。方法　比较 78例 70岁以上OPCAB和 32例 70岁以上常规体外循环冠状动脉旁路移植术 (CCABG)的临床资料。结果　两组术后桥通畅率均为 10 0 % ,OPCAB和CCABG两组平均住院时间 (9 2 5± 4 0 3)d对(13 18± 7 5 4)d ,平均ICU时间 (2 4 0± 8 5 )h对 (38 5± 2 5 5 )h ,房颤发生率为 8%对 15 %。结论　老年病人有选择的施行OPCAB是一种合理和安全的术式 ,如果可能的话应尽量考虑采用此术式。     

非体外循环冠状动脉旁路移植术在肾功能不全患者中的应用

目的通过对非体外循环冠状动脉旁路移植术(OPCAB)对肾功能的影响,评价OPCAB在合并肾功能不全的冠心病患者中的应用价值. 方法从2000年1月至2002年6月对27例合并肾功能不全的冠心病患者行单纯择期OPCAB,均为非透析者,血清肌酐均≥115 μmol/L (115～239 μmol/L) ,平均141±35 μmol/L; 观察术后12小时、36小时、第3天和第5天肌酐值的动态变化. 结果术后12小时肌酐值达到波峰(166±65 μmol/L),至术后第5天(133±38 μmol/L)降至术前水平.全组27例均治愈出院.围手术期无急性肾功能衰竭,无住院死亡. 结论 OPCAB技术是一种安全、有效的措施,它可以明显降低冠状动脉旁路移植术(CABG)后肾功能衰竭的发生,降低住院死亡率,提高患者的生活质量.     

非体外循环与常规冠状动脉旁路移植术后心肌酶的动态变化

目的通过观察非体外循环冠状动脉旁路移植术(OPCAB)与常规冠状动脉旁路移植术(CCABG)患者术后心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)的动态变化,比较两种手术方式对心肌的损伤情况.方法102例不稳定型心绞痛患者,按不同的手术方式分为OPCAB组和CCABG组.OPCAB组:71例,行OPCAB;CCABG组:31例,行CCABG.两组分别于术前、术后4、12小时、1、3、5天测定cTnI和CK-MB.结果CCABG组行旁路血管移植2～5支(2.97±0.84支),OPCAB组1～5支(2.69±0.92支);两组均无围术期心肌梗死.两组术后早期cTnI和CK-MB均有升高,分别于术后5天和术后3天基本恢复至术前水平.术后4、12小时、术后1天OPCAB组cTnI值与CCABG组比较差别有显著性意义(P<0.01).结论有选择的施行OPCAB是一种安全和合理的手术方式,OPCAB的心肌损伤程度明显轻于CCABG.     

体外循环与非循环冠状动脉旁路移植术对老年冠心病病人脏器损伤的影响

目的分析体外循环与非循环冠状动脉旁路移植术对老年冠心病病人脏器损伤的影响。方法老年冠心病病人144例,遵循随机对照试验原则行盲法分组,对照组72例,采取体外循环冠状动脉旁路移植术(CCABG),观察组72例,实施非体外循环冠状动脉旁路移植术(OPCAB)治疗,比较两组临床手术指标和并发症,监测术后不同时间节点心(CK-MB、cTnI),肺(IO),肾(BUN、SCr),肝(AST、ALT)等脏器组织及颅脑(S100B蛋白)损伤情况,随访记录术后12个月心功能(LVEF、LVEDD)改善效果,以SF-36量表评估生活质量。结果两组手术手术操作时间、搭桥数目、术后24小时内引流量比较,差异无统计学意义(P0.05),观察组血浆、全血输注量、呼吸机应用、ICU入住时间及住院恢复时间、并发症低于对照组(P0.05);观察组术毕即刻(T2)、术后24小时(T3)、术后48小时(T4)等时间节点AST、ALT、BUN、CK-MB、SCr、cTn I、S100B蛋白均低于对照组,OI高于对照组(P0.05);两组术后12个月LVEF、LVEDD比较差异无统计学意义(P0.05),观察组GH、RE、MH评分均高于对照组(P0.05)。结论 OPCAB与CCABG治疗老年冠心病均可造成脏器组织损伤,OPCAB对病人肺、心肌、肾、肝脏器及颅脑组织损伤程度均较CCABG治疗者更小,预后更佳。     

常规与非体外循环冠状动脉旁路移植术治疗冠状动脉多支病变的对比分析

目的　评价非体外循环下冠状动脉旁路移植术 (OPCAB)与常规体外循环下冠状动脉旁路移植术(CCABG)相比是否具有优越性。　方法　将 170例 2支以上血管病变行冠状动脉旁路移植术 (不包括瓣膜手术或室壁瘤切除等合并手术的病例 )患者分为 OPCAB组和 CCABG组 ,OPCAB组通过胸骨正中切口 ,在非体外循环心脏不停跳下完成冠状动脉旁路移植术 ;CCABG组建立常规体外循环 ,心脏停搏下完成冠状动脉旁路移植术。对两组病例的术前和术后各项指标进行对比分析。　结果　两组患者术前的一般情况无差异 ,OPCAB组与 CCABG组间曾行溶栓或经皮腔内冠状动脉成形术治疗和 3支病变的比例分别为 31.8%比 18.3%和 5 9%比 78% ,移植旁路血管分别为3.6± 0 .8支比 4.3± 1.0支 (P<0 .0 1) ,但所用的血管材料两组间无差异。OPCAB组术后呼吸机辅助时间和外科住院时间较短 ,住院费用较低 (P<0 .0 5 )。但术后并发症如二次开胸止血、伤口感染、心律失常、围术期心肌梗死、肺部并发症等的发生率 OPCAB组为 9.8% ,CCABG组为 14.6 % ;OPCAB组无手术死亡 ,CCABG组死亡 1例 (P>0 .0 5 )。　结论　 OPCAB治疗冠心病多支病变的初期结果显示可以减少患者术后辅助呼吸时间和外科住院时间 ,降低住院费用。但目前尚不能替代 CCABG,其近、远期效果仍     

非体外循环冠状动脉旁路移植术的病理生理与麻醉处理

冠状动脉旁路移植术(coronary artery bypass grafting,CABG)是常见的心脏手术.非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass,OPCABG)最早于1964年在圣彼得堡完成,但很快随着体外循环(cardiopulmonary bypass,CPB)技术及心脏停跳液的发展而被弃之不用.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.     

七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.