血浆脑钠肽预测OPCAB术后并发症的临床研究

目的：探讨血浆脑钠肽（BNP）水平对于评价非体外循环下冠状动脉旁路移植术（OPCAB）术后并发症的临床价值。方法：以OPCAB患者130例为研究对象。分别于手术前、术后5h、术后24h、术后72h及术后1周测定血浆BNP水平，分析术后BNP的变化趋势。将血浆BNP水平与术后早期心律失常等临床事件进行分析。结果：（1）OPCAB术后5h血浆BNP水平开始上升，72h达峰并开始下降，到1周时仍明显高于术前水平（P〈0．01）。（2）术后心律失常组术前、术后24h、72h及1周的血浆BNP水平高于非心律失常组（P〈0．01或P〈0．05）。结论：（1）OPCAB术后血浆BNP水平呈动态变化趋势。（2）术前及术后升高的血浆BNP水平可能与术后心律失常有关。

Utility of B-Natriuretic Peptide in Predicting Post Operative Complications in Patients Undergoing OPCAB

Objective:To investigate the changes of serum brain natriuretic peptide(BNP)in patients undergoing off-pump coronary artery bypass grafting(OPCAB)and to assess whether BNP could be used as predictors of postoperative complications in patients after OPCAB.Methods:There were 130 patients admitted to the study.The serum levels of BNP were measured before surgery and at 5 h,24 h,72 h and 7 d after the operation.Results:The serum levels of BNP elevated markedly at 5 h after operation and reached peak value at 72 h after operation then decreased but was still higher than before operation(P < 0.01).The serum levels of BNP were significantly higher before and at 24 h,72 h and 7 d after operation in patients with arrhythmias compared to those in patients without arrhythmias(P < 0.01 or P < 0.05).Conclusion:The elevated serum levels of BNP before and after OPCAB were associated with postoperative complications,arrhythmias.