Accuracy of myeline base protein in evaluation of brain injury in patients undergoing cardiac surgery performed under CPB / 中华麻醉学杂志

ABSTRACT

Objective To investigate the accuracy of myeline base protein (MBP) in evaluation of brain injury in patients undergoing cardiac surgery performed under CPB. Methods Thirty-two ASA Ⅱ- Ⅳ patients of both sexes (20 males, 12 females) aged 59-76 yr weighing 52-72 kg undergoing coronary artery bypass grafting (CABG) under CPB were studied. Patients with history of neurological disease were excluded. Preoperative National Institute of Health stroke scale (NIHSS) score ≤ 9. According to postoperative NIHSS score on 2nd postoperative day, the patients were divided into 3 groups group A no neurological deficit ( NIHSS score 0-9 );group B mild neurological deficit (NIHSS score 10-19) and group C moderate or severe neurological deficit (NIHSS score 20-45). Blood samples were taken from internal jugular vein before CPB (T0), at 30 min of CPB (T1), at the discontinuation of CPB (T2), and at 1, 6, 24 h after discontinuation of CPB (T3-5) for determination of the plasma MBP concentration. The duration of operation, CPB time, aortic cross-clamping time were recorded.Results In group B the plasma MBP level peaked at 6 h after CPB (T4) and then decreased rapidly while in group C the plasma MBP level exceeded the normal upper limit at T2 and kept increasing till 24 h after CPB (T5 ).The plasma MBP level decreased at T1-3.5 in group A as compared with the normal upper limit. The plasma MBPlevel was significantly higher at T3-5 in group B and at T1-5 in group C than in group A and at T1-5 in group C than in group B. Linear regression analysis indicated that there was positive correlation between plasma MBP level and CPB time at T5. NIHSS scores were positively correlated with plasma MBP level at T1 , T2, and T5. Conclusion MBP can early reflect the severity of brain injury in patients undergoing cardiac surgery under CPB.