| 引用本文: | 林中林,李大桁,李明亮,周成斌,唐靖.体外循环冠状动脉旁路移植术中三氧自体血疗法对炎症反应及红细胞损伤的保护作用[J].中国临床新医学,0,():-. |
| linzhonglin.体外循环冠状动脉旁路移植术中三氧自体血疗法对炎症反应及红细胞损伤的保护作用[J].中国临床新医学,0,():-. |
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| 摘要: |
| 目的 评估三氧自体血疗法在体外循环冠状动脉旁路移植术中对炎症反应及红细胞损伤的保护作用，并探讨其对围手术期临床结局的影响。
方法 纳入2024年10月至2025年12月行体外循环冠状动脉旁路移植术的100例患者，本研究经广东医科大学附属医院伦理委员会批准，所有患者均签署知情同意书。分为干预组和对照组各50例。干预组在体外循环开始后30分钟内接受100 mL三氧处理的自体血回输，对照组接受常规体外循环心脏手术管理。在术前、体外循环中及术后48小时内检测炎症因子（IL-6、IL-8、TNF-α、CRP）、红细胞氧化应激指标（MDA、SOD、GSH-Px）、血气分析参数及红细胞形态学变化，并记录临床结局。
结果 干预组在体外循环结束后炎症因子水平显著低于对照组（P<0.001），氧化应激指标MDA明显降低（P<0.001），而抗氧化酶SOD和GSH-Px活性增高（P<0.01）。干预组红细胞溶血率降低，形态学保存更好，带3膜蛋白相对光密度更高（P<0.01）。术后24小时干预组PaO?显著高于对照组（P<0.001）。干预组ICU停留时间（3.24±0.48天vs 3.61±0.51天，P=0.001）和住院天数（10.43±1.35天vs 11.02±1.41天，P=0.045）均较对照组明显缩短。
结论 三氧自体血疗法可有效抑制体外循环冠状动脉旁路移植术围手术期的炎症反应，减轻红细胞氧化损伤与膜结构破坏，改善术后肺功能，缩短住院时间，为体外循环心脏手术患者的围手术期保护提供了新的治疗选择。 |
| 关键词: :体外循环 三氧自体血疗法 炎症反应 红细胞 氧化应激 |
| DOI： |
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| 基金项目:恩泽疼痛管理医学研究项目编号(ezmr2022-019) |
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| Effects of Ozone Autohemotherapy on Inflammatory Response and Red Blood Cell Protection During On-pump Coronary Artery Bypass Grafting |
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linzhonglin1,2,3,4
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1.Guangdong Medical University;2.Guangdong Provincial People'3.'4.s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
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| Abstract: |
| Objective: To evaluate the protective effect of ozone autohemotherapy on inflammatory response and red blood cell injury during on-pump coronary artery bypass grafting (CABG), and to explore its influence on perioperative clinical outcomes.
Methods: A total of 100 patients undergoing on-pump CABG from October 2024 to December 2025 were enrolled. This study was approved by the Ethics Committee of the Affiliated Hospital of Guangdong Medical University, and all patients provided written informed consent. Patients were divided into an intervention group and a control group (50 cases each). The intervention group received 100 mL of ozone-treated autologous blood reinfusion within 30 minutes after the initiation of cardiopulmonary bypass (CPB), while the control group received routine CPB management.
Results: After CPB, inflammatory factor levels in the intervention group were significantly lower than those in the control group (P<0.001). The oxidative stress index MDA was significantly reduced (P<0.001), while the activities of antioxidant enzymes SOD and GSH-Px were increased (P<0.01). The intervention group showed reduced red blood cell hemolysis rates, better morphological preservation, and higher band 3 membrane protein relative optical density (P<0.01). At 24 hours postoperatively, PaO? was significantly higher in the intervention group (P<0.001). ICU stay (3.24±0.48 days vs 3.61±0.51 days, P=0.001) and hospital stay (10.43±1.35 days vs 11.02±1.41 days, P=0.045) were significantly shorter in the intervention group.
Conclusion: Ozone autohemotherapy can effectively inhibit the perioperative inflammatory response during on-pump CABG, reduce erythrocyte oxidative damage and membrane structural destruction, improve postoperative pulmonary function, and shorten hospital stay. |
| Key words: : Cardiopulmonary bypass Ozone autohemotherapy Inflammatory response Red blood cells Oxidative stress |
