Journal of Clinical PracticeJournal of Clinical PracticeКлиническая практика2220-30952618-8627Eco-Vector10784710.17816/clinpract107847Original Study ArticlesОригинальные исследованияResearch ArticleInduced blood oxidation in myocardial revascularizationПоказатели индуцированного окисления крови при проведении реваскуляризации миокардаhttps://orcid.org/0000-0002-5362-87023521-7810ShereshnevaMarina V.ШерешневаМарина Владимировна
Russian Federation
m.shereshneva@yandex.ruhttps://orcid.org/0000-0001-6278-374X2936-4312IlyinMikhail V.ИльинМихаил Витальевич
Russian Federation

МD, PhD, Associate Professor

д.м.н., доцент

dekanat-2011@mail.ruhttps://orcid.org/0000-0001-5219-21453806-1033SandugeyAnna V.СандугейАнна Владимировна
Russian Federation

МD, PhD, Assistent

к.м.н., ассистент

sandugey1@yandex.ruhttps://orcid.org/0000-0003-2385-74569315-6570ZotovAlexander S.ЗотовАлександр Сергеевич
Russian Federation

МD, PhD

к.м.н.

zotov.alex.az@gmail.comYaroslavl State Medical UniversityЯрославский государственный медицинский университетFederal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological AgencyФедеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства России200620220307202213220281605202207062022Copyright ©; 2022, Shereshneva M.V., Ilyin M.V., Sandugey A.V., Zotov A.S.Copyright ©; 2022, Шерешнева М.В., Ильин М.В., Сандугей А.В., Зотов А.С.2022Shereshneva M.V., Ilyin M.V., Sandugey A.V., Zotov A.S.Шерешнева М.В., Ильин М.В., Сандугей А.В., Зотов А.С.https://creativecommons.org/licenses/by-nc-nd/4.0https://clinpractice.ru/clinpractice/article/view/107847

Background: The use of artificial circulation in surgical myocardial revascularization is one of the key pathogenetic factors in the development of the oxidative stress and systemic inflammatory response in the postoperative period. Aims: the purpose of the study was to describe the dynamics of the induced blood oxidation parameters during coronary artery bypass surgery in the conditions of artificial circulation and on the working heart. Methods: The study included 64 patients who underwent coronary bypass surgery, with 31 (48.4%) on-pump patients and 33 (51.6%) off-pump patients. The oxidative stress simulations were conducted under the in vitro conditions. The blood oxidation-induced values were studied using a biological oxygen monitor. Results: In patients with coronary heart disease, regardless of the choice of the revascularization method (on-pump / off-pump), we observed statistically significantly (p <0.05) higher initial and maximum blood oxidation rates, the oxidative activity factor, and a shorter initiation period than those in healthy volunteers. No significant differences were found by the inter-group comparison analysis both 10 days and 6 months post-surgery. Conclusion: The indicators of induced blood oxidation do not depend on the method of revascularization during coronary bypass grafting (artificial circulation or a working heart). The changes in the parameters indicating activation of the oxidative and antioxidant blood systems may be transient by their nature and occur in the early postoperative period.

Обоснование. Применение искусственного кровообращения при проведении хирургической реваскуляризации миокарда является одним из ключевых патогенетических факторов в развитии окислительного стресса и системного воспалительного ответа в послеоперационном периоде. Цель исследования — изучение динамики показателей индуцированного окисления крови при шунтировании коронарных артерий в условиях искусственного кровообращения и на работающем сердце. Методы. В исследование включены 64 пациента, которым было выполнено коронарное шунтирование, из них 31 (48,4%) прооперирован в условиях искусственного кровообращения (on-pump), 33 (51,6%) — с вмешательством на работающем сердце (off-pump). Моделирование окислительного стресса проводилось в условиях in vitro. Показатели индуцированного окисления крови изучались с помощью биологического кислородного монитора. Результаты. У больных ишемической болезнью сердца вне зависимости от выбора методики реваскуляризации (on-pump / off-pump) наблюдались статистически значимо (p <0,05) более высокие, чем у здоровых добровольцев, показатели инициальной и максимальной скорости окисления крови, коэффициент окислительной активности и более короткий период инициации. При проведении межгруппового сравнительного анализа значимых различий не наблюдалось как через 10 сут, так и через 6 мес после операции. Заключение. Показатели индуцированного окисления крови не зависят от метода реваскуляризации — коронарного шунтирования в условиях искусственного кровообращения или на работающем сердце. Изменения показателей, свидетельствующие об активации окислительной и антиоксидантной систем крови, могут носить транзиторный характер и возникать в раннем послеоперационном периоде.

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