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《Journal of Chinese Practical Diagnosis and Therapy》 2017-11
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Effect of fast-track anesthesia on myocardial oxidative stress injury and miR-1 in children with congenital heart disease undergoing cardiac surgery

MO Wei-bo;LI Bi-wan;TAN Wen-hao;LU Bin-tang;ZHANG Bi-ying;Department of Anesthesiology,the Second People's Hospital of Qinzhou;  
Objective To evaluate the effect of fast-track anesthesia(FTA)on myocardial oxidative stress injury and miR-1 in peripheral blood in children with congenital heart disease undergoing cardiac surgery.Methods A total of 120 children with congenital heart disease undergoing cardiac surgery were randomly divided into FTA group undergoing FTA and control group undergoing general anesthesia,with 60 children in each group.The changes of cardiac troponin I(cTnI),malonaldehyde(MDA),superoxide dismutase(SOD)activity and miR-1 were observed and compared at the time points of before aortic cross-clamping(T0),15 min after cross clamping remission(CCR)(T1),30 min after CCR(T2),60 min after CCR(T3)and 180 min after CCR(T4)between two groups.Pearson correlation analysis was used to study the relationship of miR-1 with the levels of cTnI,MDA and SOD activity.Results There were no significant differences in the operation lasting time,cardiopulmonary bypass time and aortic clamping time between two groups(P0.05).There were no significant differences in the levels of cTnI((0.25±0.02)μg/L vs(0.24±0.03)μg/L),MDA((4.09±0.87)μmol/L vs(4.15±0.74)μmol/L),SOD activity((43.28±9.68)u/mL vs(42.76±8.54)u/mL)and miR-1(0.36±0.05 vs 0.35±0.06)between FTA group and control group(P0.05).The levels of cTnI((1.89±0.28),(2.67±0.36),(3.62±0.48),(2.76±0.32)μg/L),MDA((5.21±0.78),(6.47±0.95),(8.23±1.15),(6.09±0.91)μmol/L),SOD activity((52.45±9.36),(64.73±11.36),(75.75±11.57),(59.57±8.74)u/mL)and miR-1(2.03±0.13,3.28±0.15,4.03±0.16,3.18±0.13)at T1 to T4 in FTA group were significantly lower than those in control group(cTnI:(2.85±0.30),(3.35±0.40),(5.51±0.62),(4.12±0.55)μg/L;MDA:(6.63±1.06),(7.94±1.21),(9.82±1.28),(7.26±0.98)μmol/L;SOD:(65.21±10.26),(73.74±9.85),(84.36±14.79),(68.64±12.62)u/mL;miR-1:2.95±0.11,4.73±0.14,6.37±0.18,4.63±0.15)(P0.05),all the above indexes were significantly higher than those at T0(P0.05).Pearson correlation analysis showed that the level of miR-1 was positively correlated with the levels of cTnI,MDA and SOD activity in two groups(r=0.543,P0.001;r=0.723,P0.001;r=0.639,P0.001).Conclusion MiR-1 may be used as a serum marker for assessing myocardial injury and oxidative stress in aortic cross-clamping and remission in children with congenital heart disease undergoing cardiac surgery.FTA can significantly protect myocardium by relieving myocardial injury and oxidative stress and reducing the peripheral blood level of miR-1.
【Fund】: 广西壮族自治区卫生和计划生育委员会自筹经费课题项目(Z2013736);; 钦州市科技攻关项目(20164504)
【CateGory Index】: R726.1
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