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目的 探讨不停跳冠脉旁路移植(OPCABG)术后患者心肌酶明显升高的相关因素及与早期并发症的关系,指导临床上OPCABG患者围手术期处理.方法 选取2015年1月至2016年6月行OPCABG手术患者214例,术后测定12、24、48 h肌酸激酶同工酶(CK-MB),将CK-MB≤5.31 ng/mL患者纳入轻度升高组(n=167例),>5.31 ng/mL纳入明显升高组(n=47例).将两组围手术期临床数据进行统计学对比及 Logistic 回归分析.结果 Logistic回归分析发现,术前24 h有心绞痛发作、前降支桥位置位于中远或远段、搭桥手术时间是OPCABG术后CK-MB明显升高的相关因素.CK-MB明显升高的患者术后心电图 ST段改变、低血压及围手术期心梗(PMI)发病率更高(P5.31 ng/mL were classified into group B. The clin-ical data of the two groups were compared and analyzed with Logistic regression analysis. Results The relevant factors included occurrence of angina pectoris 24 h before operation,the graft located at the distal or middle-distal segment of left anterior descending artery (LAD), and operation time for bypass surgery. Group B had higher incidences of ECG ST segment change, hypotention, and perioperative myocardial infarction (PMI) than group A (P <0.05). Conclusions If preoperative angina pectoris is frequent,or the left internal mammary artery is bridged at the distal or middle-distal segment of LAD,or the graft time is too long,early complications such as significantly elevated enzymes, ECG ST segment changes,hypotension,and PMI may occur after OPCABG in patients with graft patency.