2023 年第 11 期 第 18 卷

糖尿病对停跳冠状动脉旁路移植术患者体外循环过程中炎症因子的影响

Effect of diabetes mellitus on inflammatory factors levels during cardiopulmonary bypass in patients during on-pump coronary artery bypass grafting

作者：李豪1李磊2苏俊武3侯文明2李子军2胡运洁2刘宝堂2刘效波2

英文作者：Li Hao1 Li Lei2 Su Junwu3 Hou Wenming2 Li Zijun2 Hu Yunjie2 Liu Baotang2  Liu Xiaobo2

单位：1潍坊医学院临床医学院，潍坊261000；2潍坊医学院附属医院心血管外科，潍坊261035；3首都医科大学附属北京安贞医院小儿心脏中心外科，北京100029

英文单位：1School of Clinical of Medicine Weifang Medical University Weifang 261000 China; 2Department of Cardiovascular Surgery Affiliated Hospital of Weifang Medical University Weifang 261035 China; 3Department of Pediatric Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；2型糖尿病；体外循环；炎症因子

英文关键词：Coronaryatheroscleroticheartdisease;Type2diabetesmellitus;Cardiopulmonarybypass;Inflammatoryfactors

• 摘要：

• 目的  探讨糖尿病对停跳冠状动脉旁路移植术患者体外循环过程中炎症因子的影响。方法  采用前瞻性研究的方法，选取2020年6月至2022年6月在潍坊医学院附属医院心血管外科行停跳冠状动脉旁路移植术的患者88例，其中合并2型糖尿病患者40例作为观察组，未合并2型糖尿病患者48例作为对照组。分别在体外循环开始时、体外循环开始30 min时、体外循环结束时抽取静脉血3 ml，采用酶联免疫吸附试验法检测肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）和IL-8水平。结果  体外循环开始时，2组TNF-α、IL-6、IL-8水平比较，差异均无统计学意义（均P＞0.05）；体外循环开始30 min时和体外循环结束时，观察组TNF-α、IL-6、IL-8水平均高于对照组［体外循环开始30 min时：（53.2±2.4）ng/L比（43.2±6.3）ng/L、（50±6）ng/L比（40±5）ng/L、（32.2±4.3）ng/L比（24.0±3.5）ng/L；体外循环结束时：（78.5±6.9）ng/L比（61.6±5.2）ng/L、（135±38）ng/L比（80±20）ng/L、（78.9±16.7）ng/L比（48.1±12.0）ng/L］，差异均有统计学意义（均P＜0.05）。结论  在停跳冠状动脉旁路移植术体外循环过程中，合并2型糖尿病的患者炎症因子TNF-α、IL-6、IL-8水平增加更显著。

• Objective  To investigate the effect of diabetes mellitus on inflammatory factors during cardiopulmonary bypass (CPB) in patients undergoing on-pump coronary artery bypass grafting. Methods  A prospective study was conducted on 88 patients with on-pump coronary artery bypass grafting admitted to the Department of Cardiovascular Surgery, Affiliated Hospital of Weifang Medical University from June 2020 to June 2022. Among them, 40 patients with type 2 diabetes mellitus (T2DM) were selected as the observation group, and 48 patients without diabetes mellitus were selected as the control group. Venous blood (3 ml) was collected at CPB starting, 30 min after CPB starting  and immediately after CPB. The levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and IL-8 were compared between the two groups. Results  There were no significant differences in the levels of TNF-α, IL-6 and IL-8 between the two groups at CPB starting (all P＞0.05). The levels of TNF-α, IL-6 and IL-8 in the observation group were higher than those in the control group at 30 min after CPB starting and immediately after CPB ［30 min after CPB starting：(53.2±2.4)ng/L vs (43.2±6.3)ng/L, (50±6)ng/L vs (40±5)ng/L, (32.2±4.3)ng/L vs (24.0±3.5)ng/L；immediately after CPB：(78.5±6.9)ng/L vs (61.6±5.2)ng/L, (135±38)ng/L vs (80±20)ng/L, (78.9±16.7)ng/L vs (48.1±12.0)ng/L］(all P＜0.05). Conclusion  The levels of inflammatory factors TNF-α, IL-6 and IL-8 are increased more significantly in patients with T2DM and on-pump coronary artery bypass grafting during CPB.