Effects of Remote Ischemic Preconditioning With Postconditioning in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery - Randomized Controlled Trial -
Effects of Remote Ischemic Preconditioning With Postconditioning in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery - Randomized Controlled Trial -
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DOI：
10.1253/circj.cj-11-1068
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发表时间：
2012-04-01
影响因子：
3.3
通讯作者：
Hwang, Ho Young
中科院分区：
文献类型：
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作者：
Hong, Deok Man;Jeon, Yunseok;Hwang, Ho Young
背景：心肌损伤与非体外循环冠状动脉搭桥术(OPCAB)后的不良结局有关。方法与结果：70例OPCAB患者随机分为RIPC+RIPostC组和对照组，每组35例。RIPC+RIPostC组在吻合前(RIPC)和吻合后(RIPostC)分别进行4个循环的5min缺血和5min再灌注。RIPC+RIPostC可显著降低术后血清肌钙蛋白I水平(P=0.001)。术后肌钙蛋白I曲线下面积RIPC+RIPostC组降低48.7%(中位数范围21.3h·ng(-1)·ml(-1)，16.5~53.1h.ng(-1).ml(-1)vs.41.5h.ng(-1).ml(-1)，24.6~90.2h.ng(-1).ml(-1)，P=0.020)。两组患者术后肌酐水平及PaO2/FO2比值差异无统计学意义。结论：OPCAB患者术后肢体缺血RIPC+RIPostC可使术后心肌酶升高降低近一半。(保监会J 2012；76：884-890)
Background: Myocardial injury is associated with an adverse outcome after off-pump coronary artery bypass graft surgery (OPCAB). The authors conducted a randomized controlled trial to evaluate whether remote ischemic preconditioning (RIPC) with remote ischemic postconditioning (RIPostC) reduces myocardial injury in patients undergoing OPCAB.Methods and Results: Seventy patients scheduled for OPCAB were randomly assigned to an RIPC+RIPostC group (n=35) or a control group (n=35). In the RIPC+RIPostC group, 4 cycles of 5-min ischemia and 5-min reperfusion were done on a lower limb before anastomoses (RIPC) and after anastomoses (RIPostC). RIPC+RIPostC significantly reduced postoperative serum troponin I levels (P=0.001). The area under the curve for postoperative troponin I was 48.7% lower in the RIPC+RIPostC group (median [interguartile range], 21.3 h.ng(-1).ml(-1), 16.5-53.1 h.ng(-1).ml(-1) vs. 41.5 h.ng(-1).ml(-1), 24.6-90.2 h.ng(-1).ml(-1), P=0.020). There was no significant difference in creatinine levels and PaO2/FO2 ratios between the 2 groups.Conclusions: RIPC+RIPostC by lower limb ischemia decreased postoperative myocardial enzyme elevation by almost half postoperatively in patients undergoing OPCAB. (Circ J 2012; 76: 884-890)