涎液化糖链抗原-6(KL-6)与体外循环中行持续低潮气量通气的成年瓣膜患者围术期肺氧合功能改变的相关性研究

注册号:

Registration number:

ChiCTR1800017334 

最近更新日期:

Date of Last Refreshed on:

2018-07-25 07:46:02 

注册时间:

Date of Registration:

2018-07-25 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

涎液化糖链抗原-6(KL-6)与体外循环中行持续低潮气量通气的成年瓣膜患者围术期肺氧合功能改变的相关性研究

Public title:

Clinical correlation research of Krebs von den Lungen-6 (KL-6) and perioperative pulmonary function in adults receiving continuing low-volume ventilation during valve surgery

注册题目简写:

English Acronym:

研究课题的正式科学名称:

涎液化糖链抗原-6(KL-6)与体外循环中行持续低潮气量通气的成年瓣膜患者围术期肺氧合功能改变的相关性研究

Scientific title:

Clinical correlation research of Krebs von den Lungen-6 (KL-6) and perioperative pulmonary function in adults receiving continuing low-volume ventilation during valve surgery

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

沈嘉渝 

研究负责人:

胡佳 

Applicant:

Jia-yu Shen 

Study leader:

Jia Hu 

申请注册联系人电话:

Applicant telephone:

+86 15708423711

研究负责人电话:

Study leader's
telephone:

+86 18682560211

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

495645314@qq.com

研究负责人电子邮件:

Study leader's E-mail:

humanjia@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

四川省成都市国学巷37号

研究负责人通讯地址:

四川省成都市国学巷37号

Applicant address:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

Study leader's address:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

四川大学华西医院心脏大血管外科

Applicant's institution:

Department of Cardiovascular Surgery, West China Hospital of Sichuan University

研究负责人所在单位:

四川大学华西医院

Affiliation of the Leader:

West China Hospital, Sichuan University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2017-322

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

四川大学华西医院生物医学伦理分委会

Name of the ethic committee:

Biomedical Research Ethics Committee, West China Hospital, Sichuan University

伦理委员会批准日期:

Date of approved by ethic committee:

2017-12-06 00:00:00

伦理委员会联系人:

曾智

Contact Name of the ethic committee:

Zhi Zeng

伦理委员会联系地址:

四川省成都市国学巷37号

Contact Address of the ethic committee:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

四川大学华西医院

Primary sponsor:

West China Hospital, Sichuan University

研究实施负责(组长)单位地址:

四川省成都市国学巷37号

Primary sponsor's address:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

四川

市(区县):

Country:

China

Province:

Sichuan

City:

单位(医院):

华西医院

具体地址:

四川省成都市国学巷37号

Institution
hospital:

West China Hospital, Sichuan University

Address:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

经费或物资来源:

四川大学华西医院科研经费

Source(s) of funding:

West China hospital research funding of Sichuan university

研究疾病:

急性肺损伤  

Target disease:

acute lung injury

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

初步探讨体外循环术中持续低潮气量通气对成年瓣膜患者体内KL-6的表达水平及患者围术期肺氧合功能变化的影响,评估KL-6与此类患者围术期氧合功能改变的相关性。  

Objectives of Study:

This study was designed to investigate the influence of continuous low-volume ventilation used in cardiopulmonary bypass to the expression level of KL-6 and perioperative pulmonary function in adults undergoing valve surgery, and to explore the relationship of KL-6 and those patients perioperative pulmonary function.

药物成份或治疗方案详述:

连续纳入2017年9月至2018年1月在华西医院心脏大血管外科接受心脏瓣膜手术成年患者60例进行前瞻性对照研究,根据体外循环(Cardiopulmonary bypass, CPB)术中有无机械通气分为对照组(组I,n=30例,体外循环期间未接受机械通气)和实验组(组II,n=30例,体外循环期间接受持续低潮气量通气,机械通气参数:潮气量3ml/kg,通气频率12次/min,给氧浓度50%,呼气末正压5cmH2O)。利用酶联免疫反应吸附技术(enzyme linked immunosorbent assay,ELISA)定量测定患者血清白细胞介素-6(Interleukin 6,IL-6)、白细胞介素-8(Interleukin 8, IL-8)、白细胞介素-10(Interleukin 10, IL-10)和KL-6在开胸后、主动脉开放±5min、主动脉开放1h±5min、主动脉开放2h±5min、主动脉开放4h±5min、主动脉开放8h±5min等时间点的表达水平。同时,利用ELISA技术检测主动脉开放后12~24小时内患者肺泡灌洗液中上述生物标志物的表达水平。通过动脉血气分析动态监测患者围术期氧合功能及肺泡-动脉氧分压差的变化情况。对比观察两组患者围术期相关临床结局。 

Description for medicine or protocol of treatment in detail:

From September 2017 to January 2018, sixty patients who received valve replacement surgery in west China hospital were prospectively enrolled. According to the ventilation mode during CPB, those patients were randomly allocated into two groups, control group (Group I, n=30, non-ventilation), and experiment group (Group II, n=30, 3ml/kg tidal volume, 12/min frequency, 50% FiO2, 5cmH2O positive end expiratory pressure). The expression levels of serum interleukin 6,8,10 (as inflammatory) and KL-6 (as a marker for pulmonary injury) were determined using enzyme linked immunosorbent assay (ELISA) preoperatively, at the time of aortic declamping and one, two, four, six and eight hours after aorfffftic declamping. Levels of these biomarkers in bronchoalveolar lavage fluid (BALF) and serum were also determined within 12~24 hours after aortic declamping. The ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) and alveolar-arterial oxygen tension difference (AaDO2) were recorded during those same time points. And the patients perioperative clinical outcomes also have been compared. 

纳入标准:

Inclusion criteria

排除标准:

(1) 再次心脏手术者;
(2) 患者术前需接受机械通气治疗;
(3) 急性主动脉夹层合并瓣膜病变者;
(4) 患者术前有严重肝、肾功能疾患者;
(5) 术前戒烟时间<3月者;
(6) 术前存在严重胸廓畸形者;
(7) 术前有其他心血管疾病、骨骼肌疾病或免疫系统疾病;
(8) 术前有肿瘤病史者;
(9) 麻醉药物过敏史;
(10) 恶性高热家族史;
(11) 酒精依赖或长期服用镇静催眠药物;
(12) 术前存在出凝血功能异常者;
(13) 术前合并感染性心内膜炎;
(14) 术前合并先天性心脏病;
(15) 术前合并冠状动脉粥样硬化性心脏病;
(16) 术前合并重症肌无力;
(17) 术前合并血小板减少;
(18) 合并有基础肺部疾病、COPD或中重度以上肺功能受损的患者;
(19) PaO2<80mmHg和(或)PCO2>45mmHg;
(20) 不愿参加研究患者;
(21) 已被纳入其他研究项目患者。

Exclusion criteria:

(1) Reoperation;
(2) Preoperative mechanical ventilation'
(3) Acute arotic dissection with valve diseases;
(4) Preoperative liver dysfunction or chronic kidney diseases;
(5) Quit smoking time shorter than three months;
(6) Preoperative severe thoracic deformity;
(7) Preoperative other cardic diseases, immune system diseases or musculoskeletal diseases;
(8) History of tumor diseases;
(9) History of allergic to anaesthetic;
(10) History of malignant hyperthermia;
(11) History of alcohol or sedative dependence;
(12) Preoperative Coagulation disorders;
(13) Preoperative infective endocarditis;
(14) Congenital heart diseases;
(15) Coronary artery diseases;
(16) Myasthenia gravis;
(17) Thrombocytopenia;
(18) Preoperative pulmonary dysfunction or COPD;
(19) PaO2<80mmHg or PCO2>45mmHg;
(20) Unwilling to join in this research;
(21) Have been included in other programmes.

研究实施时间:

Study execute time:

From 2017-12-01 00:00:00 To 2018-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2018-01-01 00:00:00 To 2018-06-30 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

30

Group:

Control group

Sample size:

干预措施:

体外循环术中暂停机械通气

干预措施代码:

Intervention:

no mechanical ventilation during CPB

Intervention code:

组别:

试验组

样本量:

30

Group:

Experimental group

Sample size:

干预措施:

体外循环术中持续低潮气量通气

干预措施代码:

Intervention:

Continuing low-volum ventilation during CPB

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

四川 

市(区县):

成都 

Country:

China

Province:

Sichuan

City:

Chengdu

单位(医院):

华西医院 

单位级别:

三级甲等综合性医院 

Institution
hospital:

West China hospital

Level of the institution:

Tertiary A Hospital

测量指标:

Outcomes:

指标中文名:

白细胞介素-6

指标类型:

主要指标

Outcome:

Interleukin-6

Type:

Primary indicator

测量时间点:

开胸后、主动脉开放±5min、主动脉开放1h±5min、主动脉开放2h±5min、主动脉开放4h±5min、主动脉开放8h±5min

测量方法:

酶联免疫吸附法

Measure time point of outcome:

After thoracotomy; aortic declamping±5min; aortic declamping 1h±5min; aortic declamping 2h±5min; aortic declamping 4h±5min; aortic declamping 8h±5min

Measure method:

ELISA

指标中文名:

白细胞介素-8

指标类型:

主要指标

Outcome:

Interleukin-8

Type:

Primary indicator

测量时间点:

开胸后、主动脉开放±5min、主动脉开放1h±5min、主动脉开放2h±5min、主动脉开放4h±5min、主动脉开放8h±5min

测量方法:

酶联免疫吸附法

Measure time point of outcome:

After thoracotomy; aortic declamping±5min; aortic declamping 1h±5min; aortic declamping 2h±5min; aortic declamping 4h±5min; aortic declamping 8h±5min

Measure method:

ELISA

指标中文名:

白细胞介素-10

指标类型:

主要指标

Outcome:

Interleukin-10

Type:

Primary indicator

测量时间点:

开胸后、主动脉开放±5min、主动脉开放1h±5min、主动脉开放2h±5min、主动脉开放4h±5min、主动脉开放8h±5min

测量方法:

酶联免疫吸附法

Measure time point of outcome:

After thoracotomy; aortic declamping±5min; aortic declamping 1h±5min; aortic declamping 2h±5min; aortic declamping 4h±5min; aortic declamping 8h±5min

Measure method:

ELISA

指标中文名:

涎液化糖链抗原-6

指标类型:

主要指标

Outcome:

Krebs von den lungen-6

Type:

Primary indicator

测量时间点:

开胸后、主动脉开放±5min、主动脉开放1h±5min、主动脉开放2h±5min、主动脉开放4h±5min、主动脉开放8h±5min

测量方法:

酶联免疫吸附法

Measure time point of outcome:

After thoracotomy; aortic declamping±5min; aortic declamping 1h±5min; aortic declamping 2h±5min; aortic declamping 4h±5min; aortic declamping 8h±5min

Measure method:

ELISA

指标中文名:

氧合指数

指标类型:

主要指标

Outcome:

PaO2/FiO2

Type:

Primary indicator

测量时间点:

开胸后、主动脉开放±5min、主动脉开放1h±5min、主动脉开放2h±5min、主动脉开放4h±5min、主动脉开放8h±5min

测量方法:

动脉血气分析

Measure time point of outcome:

After thoracotomy; aortic declamping±5min; aortic declamping 1h±5min; aortic declamping 2h±5min; aortic declamping 4h±5min; aortic declamping 8h±5min

Measure method:

arterial blood gas analysis

指标中文名:

肺泡动脉-氧分压差

指标类型:

主要指标

Outcome:

PA-aO2

Type:

Primary indicator

测量时间点:

开胸后、主动脉开放±5min、主动脉开放1h±5min、主动脉开放2h±5min、主动脉开放4h±5min、主动脉开放8h±5min

测量方法:

动脉血气分析

Measure time point of outcome:

After thoracotomy; aortic declamping±5min; aortic declamping 1h±5min; aortic declamping 2h±5min; aortic declamping 4h±5min; aortic declamping 8h±5min

Measure method:

arterial blood gas analysis

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血清

组织:

血清

Sample Name:

Serum

Tissue:

Serum

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 100 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

研究人员采用蒙特卡洛法产生随机序列

Randomization Procedure (please state who generates the random number sequence and by what method):

Experimenters use Monte Carlo method to produce random sequence

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Not stated

Blinding:

Not stated

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

2018年8月1日 网络平台:http://www.chictr.org.cn/showproj.aspx?proj=26984

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

01/08/2018 webline:http://www.chictr.org.cn/showproj.aspx?proj=26984

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

由CRF表进行数据采集,由EDC进行数据管理

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection: CRF Data management: ResMan

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2018-07-25 07:46:02