体外循环心脏手术患者肝功能的表达水平及腺苷蛋氨酸的干预机制研究.

Objective: To study the expression level of liver function in patients of cardiac surgery with cardiopulmonary bypass and the intervention mechanism of ademetionine. Methods: A total of 184 patients underwent cardiopulmonary bypass surgery in the Second Affiliated Hospital of Hainan Medical University from May 2017 to June 2018 were selected, and were divided into observation group and the control group according to random number table method, with 92 cases in each group. The liver function indexes levels of all the patients before and after operation were compared respectively. After surgery, the patients in the control group were given saline intervention for 7d, and the patients in the observation group were given ademetionine intervention for 7 d. The liver function indexes,inflammatory response indexes and myocardial injury indexes between the two groups were compared after seven days of intervention.Results: The total bilirubin(TBI), direct bilirubin(DBI), alanine aminotransferase(ALT), aspartate aminotransferase(AST) levels before surgery were significantly lower than those after surgery, the differences were statistically significant(P <0.05). After seven days of intervention, the TBI, DBI, ALT, AST, serum tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8), creatine kinase isoenzyme(CK-MB), cardiac troponin T(cTnT) levels of observation group were significantly lower than those of the control group,and the interleukin-10(IL-10) level of observation group was significantly higher than that of the control group, the differences were statistically significant(P <0.05). The incidence of adverse reactions in the observation group was 7.61%(7/92), and there was no significant difference compared with 2.17%(2/92) in the control group(P>0.05). Conclusion: Cardiopulmonary bypass surgery can cause some damage to liver function, but ademetionine has certain protective effect in the patients’ liver function and myocardial tissue and can reduce the degree of inflammatory reaction at the same time, without serious adverse drug reaction. [ABSTRACT FROM AUTHOR]