Volatile Anesthetics Reduce Biochemical Markers of Brain Injury and Brain Magnesium Disorders in Patients Undergoing Coronary Artery Bypass Graft Surgery
Volatile Anesthetics Reduce Biochemical Markers of Brain Injury and Brain Magnesium Disorders in Patients Undergoing Coronary Artery Bypass Graft Surgery
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DOI：
10.1053/j.jvca.2011.10.014
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发表时间：
2012-06-01
影响因子：
2.8
通讯作者：
Pasternak, Kazimierz
中科院分区：
文献类型：
--
作者：
Dabrowski, Wojciech;Rzecki, Ziemowit;Pasternak, Kazimierz
目的：神经心理障碍是冠状动脉旁路移植术（CABG）手术最常见的并发症之一。术后脑损伤的早期诊断比较困难，主要依靠特异性脑损伤标志物的观察。本研究的目的是分析挥发性麻醉 (VA) 对接受 CABG 手术的成人患者血浆总镁和离子化动静脉镁浓度（a-vtMg 和 a-viMg）、血浆基质金属蛋白酶 9 (MMP-9) 和胶质纤维酸性蛋白 (GFAP) 的影响。 观察性研究。地点：医科大学医院心脏外科。患者和方法：在手术期间和术后早期测量研究参数。患者被分为 3 组：O 组，未接受 VA 的患者； ISO组，接受异氟烷治疗的患者；和SEV组，接受七氟烷的患者。结果：对92名患者进行了检查。 CABG 手术增加了 MMP-9 和 GFAP。 O 组的 MMP-9、GFAP 最高，a-vtMg 和 a-viMg 紊乱最严重。结论：心脏手术增加了血浆 MMP-9 和 GFAP 浓度。 O 组中 MMP-9、GFAP 以及动静脉 tMg 和 iMg 的变化显着较高。挥发性麻醉剂，如 ISO 或 SEV，降低了血浆 MMP-9、GFAP 浓度以及 a-vtMg 和 a-viMg 的干扰。 Crown 版权所有 (C) 2012 由 Elsevier Inc. 出版。保留所有权利。
Objectives: Neuropsychological disorders are some of the most common complications of coronary artery bypass graft (CABG) surgery. The early diagnosis of postoperative brain damage is difficult and mainly based on the observation of specific brain injury markers. The aim of this study was to analyze the effects of volatile anesthesia (VA) on plasma total and ionized arteriovenous magnesium concentrations in the brain circulation (a-vtMg and a-viMg), plasma matrix metalloproteinase-9 (MMP-9), and glial fibrillary acidic protein (GFAP) in adult patients undergoing CABG surgery.Design: An observational study.Setting: The Department of Cardiac Surgery in a Medical University Hospital.Patients and Methods: Studied parameters were measured during surgery and in the early postoperative period. Patients were assigned to 3 groups: group O, patients who did not receive VA; group ISO, patients who received isoflurane; and group SEV, patients who received sevoflurane.Results: Ninety-two patients were examined. CABG surgery increased MMP-9 and GFAP. The highest MMP-9, GFAP, and the most dramatic disorders in a-vtMg and a-viMg were noted in group O.Conclusions: Cardiac surgery increased plasma MMP-9 and GFAP concentrations. Changes in MMP-9, GFAP, and arteriovenous tMg and iMg were significantly higher in group O. Volatile anesthetics, such as ISO or SEV, reduced plasma MMP-9, GFAP concentrations, and disturbances in a-vtMg and a-viMg. Crown Copyright (C) 2012 Published by Elsevier Inc. All rights reserved.