摘要Objective To investigate the effects of adenosine preconditioning on the expression of myocardial tumor necrosis factor-alpha (TNF-α) mRNA and intercellular adhesion molecule-1 (ICAM-1) mRNA in patients undergoing off-pump coronary artery bypass graft (OPCABG).Methods Forty patients, aged 44-68 yr, with more than three coronary artery obstructions and the ejection fraction≥40%,undergoing elective OPCABG, were randomly divided into 2 groups (n=20 each): control group and adenosine group. Adenosine group received adenosine preconditioning, with the initial infusion rate of 50 μg. kg-1.min-1, then increasing to 100μg.kg-1.min-1after 1 min, finally increasing to 150 μg. kg-1 . min-1 after 2 min and maintaining for 7 min. Vascular anastomosis was started at 5 min after preconditioning. While the control group received normal saline instead of adenosine. Tissue samples of the right auricle were taken before preconditioning (baseline) and at 15 min after blood current retum to measure the expression of myocardial TNF-α mRNA and ICAM-1 mRNA. The myocardial ultrastructure was observed and hemodynamic parameters were monitored.Results The myocardial damage was milder in the adenosine group than in the control group. The expression of myocardial TNF-α mRNA and ICAM-1 mRNA was significantly lower in the adenosine group than in the control group ( P＜0.05).Conclusion Adenosine preconditioning can attenuate myocardial ischemia-reperfusion injury in patients undergoing OPCABG through down-regulating the expression of myocardial TNF- mRNA and ICAM-1 mRNA.