| Objective To investigate the difference in circulating endothelial cell (CECs) injuries CECs following on-pump and off-pump coronary-artery bypass surgery.Methods We randomly assigned 48 patients scheduled for urgent or elective coronary artery bypass grafting into two groups to receive on-pump and off-pump procedures. Blood samples were obtained before anesthesia, at the end of operation, and on days 1 and 3 after the operation, and CECs were isolated using dynabeads coated with the specific antibody of CD 146 and counted. Single cell gel electrophoresis was used to observe the morphological changes of the CECs. Results To all patient,There were not the condition which the surgery was changed or suspend because of any reason.All patients during two groups recovered well,there was no death.In CPB group, The number of CECs at the end of surgery [30 (22～45.5)/mL] and after 1 day [28.5 (16.5～40)/mL] were significantly higher than the off-pump group [21.5 (12～39)/mL] and [18(11.5～30)/mL] respectively (P<0.05).3 days after surgery, the number of CECs in CPB group [16 (9.5～23.5)/mL] and off-pump group [11.5 (6～16.5)/mL], there was no significant difference (P> 0.05); at the same time,There was no significant difference compared to the anaesthesia in CPB group [21 (9.5～37.5)/mL] (P=0.180> 0.05), In off-pump group, the number of CECs was significantly reduced compared to anaesthesia [20.5 (12～38)/mL] (P=0.004<0.05). Single cell gel electrophoresis observed that there was no significant difference about the length of CECs' comet tail and fluorescence intensity between CPB group and off-pump group in the preoperative; at the end of surgery, The set of images had changed. Compared to those before anesthesia,The comet's tail became longer and the fluorescence intensity was increased in the CPB group and non-CPB group.The changes is more obvious in CPB group, the length of its tail longer than the off-pump group and a higher proportion of changes in the cells,fluorescence intensity significantly higher than off-pump group. Meanwhile, Before anesthesia, DNA damage points of circulating endothelial cells [(20.5±4.1) points] were lower than the CPB group and non-CPB group, but DNA damage in the off-pump group [(40.1±5.0) points] was lower than the CPB group [(56.6±8.7) points], Using group analysis of variance among the 3 groups (F=129.3, P<0.01), and LSD multiple comparison method showed that the mean was significance statistically difference during any two groups (P<0.01).Conclusion:Compared to non-pump coronary artery bypass grafting,the damage of circulating endothelial cells was more serious than conventional coronary artery bypass grafting, which is closely related to the prognosis. On the whole, circulating endothelial cells will be recoved to preoperative levels in a relatively short period of time (3 days) after coronary bypass surgery, even lower than before surgery. These proved that the surgery is well definitely for coronary heart disease patients.
|
PDF Full Text Request