Prediction function of preoperative B-type natriuretic peptide in patients to receive on-pump coronary artery bypass grafting with postoperative complications / 实用医学杂志

Objective To investigate the prediction function of preoperative B-type natriuretic peptide in patients to receive on-pump coronary artery bypass grafting with postoperative complications. Methods One hundred and thirty-two patients , including 78 males and 54 females , received on-pump coronary artery bypass grafting from January 2013 to November 2014 and were enrolled in the study. The patients were (63 ± 11.35) years old ( range from 35 to 82 years). The level of BNP was determined before operation, after operation, and on day 1, 2, 3 and 7 post-operation. Relationships were analyzed between BNP and LVEF,ventilation time, length of stay in ICU, the need for inotropic agents or intra-aortic balloon pump (IABP), incidence of postoperative atrial fibrillation, and acute renal failure. Receiver operating characteristic (ROC) curve analysis was also performed to predict the role of BNP in postoperative complications. Result A negative correlation between preoperative BNP level and preoperative LVEF(r = -0.512,P < 0.05) was found. The preoperative BNP level was positively correlated with a series of adverse events. The preoperative BNP was used to predict incidence of postoperative atrial fibrillation , the possibility of using IABP , renal failure , length of stay in ICU exceeding 48h or mortality at 28 days, and the area under the ROC curve (AUC) was 0.780, 0.893, 0.818 and 0.820, respectively. Conclusion The preoperative BNP level is well correlated with the cardiac function before CABG , which may be a good predictor of postoperative complications after CABG.

Effects of Salvia miltiorrhiza and Carthamus tinctorius aqueous extracts and compatibility on rat myocardial ischemic reperfusion injury / 中国中药杂志

<p><b>OBJECTIVE</b>To separate and characterize aqueous extracts of Salvia miltiorrhiza and Carthamus tinctorius to efficient, high-throughput and strong polar components, to observe effects of their aqueous effective components compatibility on rat myocardial ischemic reperfusion injury.</p><p><b>METHOD</b>Myocardial ischemic reperfusion injury model were established on SD rats by 40 min ligation of the left anterior descending artery and 120 min reperfusion. The rats were injected experimental drugs intravenously from femoral vein after 10 min ischemia. Rats were randomly divided into sham group (the suture around the left anterior descending coronary artery was not tied), model group, Danhong injection group (content of protocatechualdehyde is 0.05 g x L(-1), injection dosage equivalent to 1.80 g x kg(-1)), aqueous effective component of S. miltiorrhiza group (content of salvianolic acid B is 49 g x L(-1), injection dosage equivalent to 30.68 g x kg(-1)), aqueous effective component of S. miltiorrhiza group (content of hydroxysafflor yellow A is 31.76 g x L(-1), injection dosage equivalent to 17.87 g x kg(-1)), aqueous effective components compatibility of S. miltiorrhizae and C. tinctorius group (injection dosage is respectively 24.28 g x kg(-1) and 48.55 g x kg(-1)), each group have ten rats. Drugs were diluted with an equal dose of normal saline. The rats of sham group and model group were injected equivalent dosage of saline. The myocardial infarction size and the contents of serum cTnT and CK-MB were detected. The level of TXB2, 6-keto-PGF(1alpha) and platelet aggregation in blood plasma were investigated.</p><p><b>RESULT</b>Compared with sham group, serum cTnT and CK-MB contents in model group increased significantly (P < 0.01). Compared with model group, myocardial infarction size and serum cTnT and CK-MB contents in aqueous effective component of S. miltiorrhiza group, aqueous effective component of C. tinctorius group and aqueous effective components compatibility of S. miltiorrhiza and C. tinctorius groups decreased significantly. Aqueous effective component of S. miltiorrhiza increased the level of 6-ke-to-PGF(1alpha), as well as decreased content of TXB2 and inhibited platelet aggregation (P < 0.01). Aqueous effective component of C. tinctorius also decreased the content TXB2 (P < 0.01). Improved extent of some detected markers in aqueous effective components compatibility of S. miltiorrhiza and C. tinctorius groups were better than that of Danhong injection group.</p><p><b>CONCLUSION</b>Effective components compatibility of aqueous extracts from S. miltiorrhiza and C. tinctorius may reduce myocardial infarct size and leakage of myocardial enzyme, and increase the level of 6-keto-PGF1alpha, so as to inhibit platelet aggregation and prevent thrombosis, the result of which is to reduce myocardial ischemic reperfusion injury.</p>

Perioperative management of coronary artery bypass grafting / 中国基层医药

Objective To review curative effect of coronary artery bypass grafting(CABG).Methods 10 patients are off-pump CABG at normal body temperature.The rest 222 were done with CPB under general anesthesia,hypothermia.Before operation cardiopulmonary function Was adjusted.During operation the function of heart,brain and renal Was carefully protected.After operation blood slucose was controlled,inflammation was prevented and pulmonary physical therapy was given to all patients.Results 226 patients discharged recovery and free of angina pectoris completely.3 patients with CABG died of low cardiac output after operation.1 patient died of effects of protamine allergy.2 patients died of multiple organ failure.Follow-up has been done in 211 patients for 2 months to 3 years,all leading normal life and working.Conclusion Careful and standardized preoperative and pefioperative treatment is one of the factors of SUCCeSSful coronary artery bypass grafting.