To investigate the difference in circulating endothelial cell (CECs) injuries following on-pump and off-pump coronary-artery bypass surgery. Methods We randomly assigned 48 patients scheduled for urgent or elective coronary artery bypass grafting into two groups to receive on-pump and off-pump procedures. Blood samples were obtained before anesthesia, at the end of operation, and on days 1 and 3 after the operation, and CECs were isolated and counted using dynabeads coated with the specific antibody of CD146. Single cell gel electrophoresis was used to observe the morphological changes of the CECs. Results In the cardiopulmonary bypass (CPB) group, the number of CECs was significantly greater than that in non-CPB group (P0.05) at the end of surgery and 1 day after the operation. On postoperative day 3, the number CECs was similar between the two groups (P>0.05). The length of the comet tail was longer in CPB group with stronger fluorescence intensity than in the non-CPB group. Conclusion Compared with of-pump coronary artery bypass grafting, on-pump coronary artery bypass grafting results in more serious CEC injury, which is closely related to the prognosis.%目的 通过研究循环内皮细胞(CECs)数量和形态的改变,探讨体外与非体外冠状动脉旁路移植术中CECs的损伤有无差异.方法 将48例需行冠状动脉旁路移植术的冠状粥样硬化疾病患者随机分为两组,分别接受体外与非体外循环下的手术治疗;在麻醉前、手术结束时、术后1d、3 d抽血,采用标记特异性抗体CD146的免疫磁珠技术分离CECs并计数;同时应用单细胞凝胶电泳技术观察CECs的DNA损伤程度.结果 体外循环组CECs数量在手术结束及术后1天均显著高于非体外循环组(P＜0.05),在术后3d,CECs数量两组无显著性差异(P＞0.05);手术结束时体外循环组"彗尾"长度明显增长,荧光强度变大.结论 体外循环较非体外循环冠状动脉旁路移植术相比,循环内皮细胞损伤严重;这些变化和预后有密切关系.
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