【摘要】 目的探讨心脏瓣膜手术联合冠状动脉旁路移植术对老年冠心病合并心脏瓣膜病患者炎症因子及心脏功能的影响。方法选择本院2012年2月~2017年2月收治的206例老年冠心病合并心脏瓣膜病患者进行研究分析,采用系统随机的方法分为对照组和观察组各103例。对照组采用心脏瓣膜手术非同期行冠状动脉旁路移植术治疗,观察组采用心脏瓣膜手术同期行冠状动脉旁路移植术治疗。对比分析两组患者术后情况及治疗前后的炎症因子及心功能变化情况。结果治疗后,观察组患者呼吸机使用时间、ICU时间、住院时间均明显低于对照组患者,组间差异明显(P<0.05)。治疗前,两组患者IL-6、TNF-α及hs-CRP水平比较无明显差异(P>0.05)。治疗后,两组患者IL-6、TNF-α及hs-CRP水平与治疗前相比明显降低(P<0.05),且观察组患者明显低于对照组(P<0.05)。治疗前,比较两组患者心功能指标无明显差异(P>0.05)。治疗后,两组患者心功能较治疗前均得到明显改善;且观察组患者改善情况明显优于对照组患者,组间比较差异明显(P<0.05)。结论心脏瓣膜手术联合冠状动脉旁路移植术对老年冠心病合并心脏瓣膜病患者进行治疗,疗效显著,能够有效改善患者的炎症因子水平及心功能,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the influence of cardiac valve surgery combined with coronary artery bypass grafting(CABG) on inflammatory factors and heart function in elderly patients with coronary heart disease(CHD) complicated by valvular heart disease(VHD). Methods The patients(n=206) were chosen from the Affiliated Hospital of Youjiang Medical University for Nationalities from Feb. 2012 to Feb. 2017, and then randomly divided into control group and observation group(each n=103). The control group was given cardiac valve surgery and asynchronous CABG, and observation group, cardiac valve surgery synchronous CABG. The post-operation conditions, and changes of inflammatory factors and heart function were compared and analyzed in 2 groups before and after operation. Results After treatment, ventilator use time, duration in ICU and length of hospital stay were all lower significantly in observation group than those in control group(P<0.05). The levels of IL-6, TNF-α and hs-CRP had no significant difference between 2 groups before operation(P>0.05), while decreased significantly in 2 groups after operation(P<0.05) and much lower in observation group than those in control group(P<0.05). The indexes of heart function had significant difference between 2 groups before operation(P>0.05). After operation, heart function was significantly improved in 2 group, which was superior in observation group to that in control group(P<0.05). Conclusion Cardiac valve surgery combined with CABG has significant curative effect, and can effectively improve levels of inflammatory factors and heart function in elderly patients with CHD complicated by VHD. It is value of clinic application.更多还原