Effects of GBE on the cytokines during open heart surgery with cardiopulmonary bypass
AIM: To explore the effect of GBE on cerebral injury caused by cardiac operation with CPB. METHODS: Forty four patients with rheumatic heart diseases undergoing cardiac valvular replacement with CPB were selected. The patients were divided into 2 groups randomly: study group and conlrol group, 22 in each group. In study group, GBE(2 mg/kg wt) was added into the CPB prime solution, whereas in control group, normal solution was adopted. Blood samples were collected at preoperation, 1 h after aortic cross-clamp, 6 h, 12 h, 24 h, 48 h after operation. Serum IL-1β, L-18 and S100 were detected. RESULTS: Serum IL-1β in control group from end of CPB increased significantly than that before. In study group, it increased significantly from 1 h after aortic cross-clamp till 48 h after operation. Serum IL-1β at 1 h after aortic cross-clamp, end of CPB, 6, 12, 24, 48 h after operation in controlgroup[(81.3 ± 32.5), (112.9 ± 50.6), (101.1 ± 38.0), (135.9 ± 42.1), (72.5 ± 27.3), (82.3 ± 20.6)ng/L, respectively] was significantly higher than that in study group [(168.3 ± 37.1), (187.2 ± 59.6), (167.2 ± 58.0), (169.5 ± 46.1), (174.4 ± 57.0), (148.8 ± 27.4) ng/L, respectively]. Serum IL-18 in control group from 6 h after operation increased significantly than that before, In study group, it increased significantly from 1 h after aortic cross-clamp till 48 h after operation. IL-18 at 1 h after aortic cross-clamp [(79.8 ± 9.2) ng/L] in control group was significantly higher than that in study group [(111.8 ± 16.8) ng/L], whereas IL-18 at 6, 12, 24, 48 h after operation in control group [(215.5 ± 43.1), (797.4 ± 178.8), (539.2 ± 83.7), (145.2 ± 35.7) ng/L, respectively] was significantly lower than that in study group [(109.2 ± 33.8), (425.8 ± 96.8), (425.5 ± 94.2), (124.1 ± 50.0) ng/L, respectively]. Serum S100 in control group increased significantly from end of CPB till end of study. There was no significant difference of serum S100 in study group. Serum S100 at 1 h after aortic cross-clamp, end of CPB, 6, 12, 24, 48 h after operation in control group [(0.350 ± 0.100) ,(0.388 ± 0.076),(0.424 ± 0.104) ,(0.516 ± 0.137), (0.486 ± 0.178),(0.460 ± 0.130)μg/L, respectively] was significantly lower than that in study group [(0.264 ± 0.071), (0.319 ± 0.086), (0.300 ± 0.091), (0.366 ± 0.077), (0.349 ± 0.064), (0.372 ± 0.125) μg/L, respectively]. CONCLUSION: Cytokine IL-18 and IL-1β during open heart surgery with CPB are involved in the cerebral injury. GBE can regulate the cytokines expression, and it can significantly reduce serum S100 protein of open heart surgery with CPB.
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万方数据
维普
