【摘要】 目的以心肌肌钙蛋白I(cTnI)作为心肌损伤的标志物,观察心肌缺血—再灌注损伤期中性粒细胞表面黏附分子CD11b在冠脉循环和外周循环的表达水平。方法选取12例择期进行冠状动脉旁路移植手术(CABG)者,分别于CPB开始前、CPB中和主动脉开放后,经冠脉循环和体循环同时取血,测定中性粒细胞表面CD11b平均荧光强度和血清cTnI浓度。结果冠脉循环和体循环血cTnI浓度在主动脉开放后均明显升高(P<0.05);CPB期间和主动脉开放后,体循环血CD11b含量不断升高,而冠脉循环内CD11b含量则呈现下降趋势,二者间差异有统计学意义(P<0.05)。结论体外循环期间,存在心肌缺血—再灌注损伤。激活的中性粒细胞有冠脉滞留效应,中性粒细胞表面CD11b表达水平在冠脉循环中下降,在体循环中升高,出现分离现象,此时单纯以冠脉循环内CD11b表达水平判定心肌缺血再灌注损伤并不全面。更多还原

【Abstract】 Objective To investigate the changes of CD11b on neutrophils during myocardial ischemia-reperfusion injury. Methods 12 patients undergoing coronary bypass grafts under CPB were studied. Blood samples were obtained from the coronary (coronary sinus) and systemic circulation (central venous and CPB machine), respectively. Samples obtained from coronary and systemic circulation were taken before the beginning of CPB, during CPB and after cardiac reperfusion. Neutrophil CD11b expression and serum cTnI concentration were measured. Results (1)Expression of CD11b increased gradually in systemic circulation during CPB and after reperfusion (P<0.05), however, it decreased in coronary sinus after the beginning of reperfusion (P<0.05). (2) The cTnI concentrations in both systemic and coronary circulation increased significantly after the beginning of reperfusion (P<0.05). Moreover, the difference between the concentrations in these two sites showed statistical significance (P<0.05). Conclusion In contrast to the increase of cTnI in both systemic and coronary circulation, the dissociation phenomenon of the expression of CD11b between these two sites may indicate that during early ischemia-reperfusion, myocardial injury exists. The possible sequestration maybe the reason which results the dissociation phenomenon of the expression of CD11b.更多还原