远程缺血预处理对全胸腔镜体外循环手术的肺保护作用

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Abstract Objective To investigate the effects of remote ischemic preconditioning（RIPC）by direct femoral artery occlusion on lung function of patients undergoing totally thoracoscopic cardiac surgery with cardiopulmonary bypass（CPB）. M ethods 60 patientswith congenital heart disease underwent thoracoscopic cardiac surgery with CPB from March 2015 to May 2016 were selected and divided into the research group（group R）and the control group（group C），30 cases in each group.After the femoral artery and vein were dissociated，group C was established CPB through the intubation directly.Group R was clamped and closed femoral artery 3 min，then open 3 min，After three cycles，the samemethod in the group Cwasused to establish CPB.Through three hole shape incision at the right chestwall，that each was 1.5 to 2.0 cm long in the third，fourth and sixth intercostals surgical field was revealed totally by thoracoscope to complete the operation.The radial artery blood was collected after tracheal intubation for 5min（T0），after cessation of CPB for 2 hours（T1），after cessation of CPB 12 hours（T2）and after cessation of CPB 24 hours（T3）.Oxygenation index was recorded by blood gas analysis.The receptor of advanced glycation end-products（RAGE）level was detected by enzyme linked immunosorbent assay（ELISA）.Results 60 patientswere all cured.Therewas no significant difference in themechanical ventilation time between the two groups（P＞0.05）.There was no significant difference in oxygenation index between the two groups in T0point（P＞0.05）.The oxygenation index of the two groups of T1-T3were all decreased.The oxygenation index of group R in T1-T3pointswas higher than that of group C at the same time，with significant difference（P＜0.05）.There was no significant difference in the level of RAGE between the two groups in T0point（P＞0.05）.The level of plasma RAGE were increased in the two groups in T1-T3points.The level of plasma RAGE of group R in T1-T3pointswas lower than that of group C at the same time，with significant difference（P＜0.05）.Conclusion RIPC by femoral artery occlusion can decrease the level of RAGE in patients underwent thoracoscopic cardiac surgery with CPB and has lung protective effects.

Key words： Remote ischemic preconditioning Thoracoscope Cardiopulmonary bypass Lung protection

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	YANG Xiao-han
	YU Hong-tao
	ZHANG Rui
	LIYa

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YANG Xiao-han,YU Hong-tao,ZHANG Rui, et al. Lung protective effect of rem ote ischem ic preconditioning on totally thoracoscopic cardiac surgery w ith cardiopulmonary bypass[J]. 中国当代医药, 2016, 23(21): 43-45转49.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2016/V23/I21/43

［1］	Bailey ML，Richter SM，Mullany DV，et al.Risk factors and survival in patients with respiratory failure after cardiac operations［J］.Ann Thorac Surg，2011，92（5）：1573-1579.
［2］	Przyklenk K，Bauer B，Ovize M，et al.Regional ischemic preconditioning protects remote virgin myocardium from subsequent sustained coronary occlusion［J］.Circulation，1993，87（3）：893-899.
［3］	Thielmann M，Kottenberg E，Kleinbongard P，et al.Cardioprotective and prognostic effects of remote ischaemic preconditioning in patients undergoing coronary artery bypass surgery：a single-centre randomised，double-blind，controlled trial［J］.Lancet，2013，382（9892）：597-604.
［4］	IIiodromitis EK，Andreadou I，IIiodromitis K，et al.Ischemicand postischemic conditioning of themyocardium in clinical practice：challenges，expectations and obstacles［J］.Cardiology，2014，129（2）：117-125.
［5］	郑兰兰，景贵霞.远程缺血预处理对心肺转流心脏瓣膜置换术患者心肌损伤的保护作用［J］.临床麻醉学杂志，2012，28（4）：343-345.
［6］	李偲，李云胜，刘家欣，等.远隔肢体缺血预处理对腹主动脉瘤手术病人肺损伤的影响［J］.中华麻醉学杂志，2012，32（3）：269-273.
［7］	吴芳，耿智隆，曹虹，等.远隔肢体缺血预处理对兔单肺缺血/再灌注损伤细胞凋亡的影响［J］.临床麻醉学杂志，2010，26（4）：342-344.
［8］	王保强，谢德红，李鹏，等.肢体缺血预适应的肝保护作用与一氧化氮/内皮素-1系统关系的研究［J］.中国应用生理学杂志，2010，26（3）：376-379.
［9］	Sorci G，Riuzzi F，Giambanco I，et al.RAGE in tissue homeostasis，repairand regeneration［J］.Biochim BiophysActa，2013，1833（1）：101-109.
［10］	Jabaudon M，Futier E，Roszyk L，et al.Soluble form of the receptor for advanced glycation end products is a marker of acute lung injury but not of severe sepsis in critically ill patients［J］.Crit Care Med，2011，39（3）：480-488.
［11］	Agostoni P，Banfi C，Brioschi M，et al.Surfactant protein B and RAGE increases in the plasma during cardiopulmonary bypass：a pilot study［J］.Eur Respir J 2011，37（4）：841-847.
［12］	Feng J，Rosenkranz ER.Bradykinin protects the rabbit heart after cardioplegic ischemia via NO-dependent pathways［J］.Ann Thorac Surg，2000，70（6）：2119-2124.
［13］	黄兆瑜，江时森.诱导型一氧化氮合酶和解偶联蛋白-2对心肌缺血预适应的作用［J］.岭南心血管病杂志，2007，13（1）：58-61.
［14］	Fantinelli JC，Pérez Núñez IA，González Arbeláez LF，et al.Participation of mitochondrial permeability transition pore in the effects of ischemic preconditioning in hypertrophied hearts：role of NO and mitoKATP［J］.Int JCardiol，2013，166（1）：173-180.
［15］	Cai ZP，Parajuli N，Zheng X，et al.Remote ischemic preconditioning confers late protection againstmyocardial ischemia-reperfusion injury in mice by upregulating interleukin-10［J］.Basic Res Cardiol，2012，107（4）：277-288.