体外循环及非体外循环冠状动脉搭桥术对血清氧自由基产生的影响

目的探讨体外循环心脏停跳下冠状动脉搭桥术(CPB-CABG)与非体外循环心脏不停跳冠状动脉搭桥术(OPCABG)对血清氧自由基产生的影响。方法选择60例首次择期行CABG的冠心病(CHD)患者,按是否应用心肺转流(CPB)随机分为CPB-CABG组和OPCABG组,每组30例。分别于术前及术后2、6、24 h采集血标本,黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)活性;硫代巴比妥酸(TBA)法测定丙二醛(MDA)含量。结果两组术前各项指标均无显著性差异(P>0.05)。两组术后2、6 h SOD活性明显降低,2、6、24 h MDA水平明显升高,与术前相比,均有显著性差异(P<0.01,P<0.05)。与CPB-CABG组相比,OPCABG组术后2、6 h SOD活性明显增加,2、6、24 h MDA水平明显降低(P<0.05)。结论OPCABG较CPB-CABG能显著减少氧自由基的产生。

Comparirasion of serum levels of oxygen free radical in patients undergoing CABG with off-pump technique or cardiopulmonary bypass

[Objective] The aim of this study was to examine the circulating levels of oxygen free radical following coronary artery bypass graft(CABG) surgery performed using both standard cardiopulmonary bypass(CPB) or the octopus technique on the beating heart.[Methods] Sixty cornoary heart disease(CHD) patients undergoing CABG surgery were randomly divided into two groups(n=30): OPCABG group,which received off-pump CABG and CPB-CABG group,which received CPB.Blood samples were obtained prior to operation and at the 2nd,6th,24thh after the end of operation.The serum superoxiside dismutase(SOD) and the malondiaehyde(MDA) were detected.[Results] In two groups,the SOD were all significantly decreased at the 2nd,6thh post-operation compared with those before operation(P< 0.01,P< 0.05).The MDA were all significantly increased at the 2nd,6th,24thh post-operation compared with those before operation(P< 0.01,P< 0.05).Compared with CPB-CABG group,the SOD of OPCABG group were markably increased at the 2nd,6th h after operation(P< 0.05) though the MDA were significantly decreased at the 2nd,6th,24th h after operation(P< 0.05).[Conclusion] It is indicated that Off-pump CABG can decrease the output of oxygen free radical than CPB-CABG.