摘要
目的:分析氟比洛芬酯预处理对体外循环下心脏瓣膜置换术患者T细胞亚群和心肌损伤的影响。方法:选取2023年1月-6月在中国人民解放军联勤保障部队第九六〇医院择期行体外循环(CPB)下心脏瓣膜置换术的40例患者,采用随机数字表法分为观察组和对照组,每组各20例。观察组于麻醉诱导前给予氟比洛芬酯注射液,对照组麻醉诱导前给予脂肪乳。分析比较两组在麻醉诱导前(T0)、停CPB 20min(T1)、术后4h(T2)、术后24h(T3)、术后48h(T4)、术后7d(T5)时外周静脉血中CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、肌钙蛋白Ⅰ(cTnI)和肌酸激酶同工酶(CK-MB)的差异。结果:观察组心外监护室停留时间短于对照组,围术期多巴胺使用量少于对照组,差异有统计学意义(P<0.05)。观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)在T1-4时点低于对照组,差异有统计学意义(P<0.05)。观察组cTnI和CK-MB分别在T2-5时点和T2-4时点低于对照组,差异有统计学意义(P<0.05)。结论:氟比洛芬酯预处理可明显改善体外循环下心脏瓣膜置换术患者T淋巴细胞的免疫功能;且能够明显减轻心肌缺血-再灌注损伤的程度,有利于患者的康复。
Objective To evaluate the effect of Flurbiprofen axetil pretreatment on T-lymphocyte subsets and myocardial injury in patients undergoing cardiac valve replacement surgery with cardiopulmonary bypass and its effectiveness.Methods Forty patients who underwent elective heart valve replacement surgery under cardiopulmonary bypass(CPB)at the 960th Hospital of the Joint Support Force of the Chinese People's Liberation Army from January 2023 to June 2023 were selected and divided into two groups using a random number table method,with 20 patients in each group.Group F received Flurbiprofen axetil injection before anesthesia induction,while Group C received fat emulsion before anesthesia induction,to analyze and compare the differences of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),Troponin inhibitorⅠ(cTnI)and Creatine kinase Isozymes(CK-MB)in the peripheral venous blood of the two groups before anesthesia induction(T_(0)),CPB20 min(T_(1)),4 h(T_(2)),24 h(T_(3)),48 h(T_(4)),and 7 d(T5).Results The stay time in the extracardiac monitoring room in Group F was shorter than that in Group C,and the perioperative dopamine use was less than that in Group C,with a statistically significant difference(P<0.05).The CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels in Group F were lower than those in Group C at T1-4,with statistically significant differences(P<0.05).The cTnI and CK-MB levels in Group F were lower than those in Group C at time points T2-5 and T2-4,respectively,with statistically significant differences(P<0.05).Conclusions Pretreatment with Flurbiprofen axetil can significantly improve the immune function of T-lymphocytes in patients undergoing cardiac valve replacement under cardiopulmonary bypass,and can significantly reduce the degree of myocardial ischemia-reperfusion injury and benefit the patients.
作者
兰新昂
高成杰
LAN Xin'ang;GAO Chengjie(Department of Anesthesiology,The 960th Hospital of the Joint Logistics Support Force of the PLA of China,Jinan,Shandong 250031,China)
出处
《医药前沿》
2023年第30期7-11,共5页
Journal of Frontiers of Medicine
关键词
氟比洛芬酯
体外循环
瓣膜置换
T细胞亚群
心肌保护
Flurbiprofen
Cardiopulmonary bypass
Valve replacement
T-lymphocyte subsets
Myocardial protection
作者简介
通信作者:高成杰。
