The Changes Level AND Clinical Value Of Plasma Thrombomodulin, Hypersensitive C-reactive Proteinn And Cardiac Tropnin I Around Cardiopulmonary Bypass

Background: CPB is a necessary method of direct-vision heart surgery.CPB can make vascular endothelial cell and cardiac muscle cell damaged. Previous studies mostly focuded on the period of during CPB or before CPB. Cardiac muscle cells and vascular endothelial cells damage take place not only during CPB but also post CPB by the forein study and national study present.The law of their injury is still not clear. Therefore,there is very important value to probeing into the vascular endothelial cell damage around CPB, make important clinical value and protecting .Objective: To investigate the law of changing and its clinical value of the plasma level of plasma TM,hsCRP and cTnI around CPB.Methods:Twenty patients following date-selective open-heart surgery by CPB were enrolled at admission for the study group (group A n=20). Blood samples were collected at 5 time points pre-operation (T₁),end-operation(T₂),one day after operation(T₃),three days after operation(T₄)and seven days after operation (T₅),and tested plasma levels of TM,hsCRP and cTnI. The plasma levels of the three markers were also tested in 20 patients with other thoractic disease needing non-CPB as the control group (group B n=20). The changes of the plasma levels of these three markers of group A at different time points were analyzed and compared with the group B, to explore respectively the correlations about of the level of TM, hsCRP and cTnI.Results: Compared the plasma level of all the markers in the group A with group B, there are no difference at T₁ the plasma TM,hsCRP and cTnI levels (p>0.05), the others times points plasma concentration are distinctness(p<0.05), and significantly increased with respect to baseline (T₁)from before operation to seven postoperative days; the plasma concentration of TM in group A is its peak between T₂ and T₃, the level of hsCRP and cTnI in group A is its peak at T₃, then decresed . But they are still higher than that in the study group's baseline(T₁) at T₅(P<0.05). The plasma concentration of TM, hsCRP in group B at T₂,T₃,T4andT5 are significantly increased with respect to baseline (T₁) (p<0.01) ,but the levels of cTnI in group B at T₂,T₃,T4andT₅ are not significantly increased with respect to baseline (T₁) (p>0.05).The corelations among TM,hsCRP and cTnI resprctively in the group A are obvious positive(0