The Effect Of Sevoflurane Postconditioning On Serum Concentration Of Troponin-T And IL-6, IL-8 In Adult Patients With Rheumatoid Heart Disease During Valve Replacement Surgery

Objective:To investigate clinically the effect of sevoflurane postconditioning on serum concentrations of troponin-T, IL-6, IL-8 for exploring its myocardial protection and relation with pro-inflammatory cytokines in adult patients with RHD during valve replacement under cardiopulmonary bypass (CPB). Methods:24 ASAâ…¡-â…¢patients scheduled for valve replacement surgery under cardiopulmonary bypass (CPB) were enrolled and divided randomly into sevoflurane postconditioning group (n=12) and control group (n=12). In sevoflurane postconditioning group,1.0 MAC sevoflurane inhaled for 10 min after aorta declamping, and in control group no sevoflurane inhaled.3ml of whole blood (WB) samples were taken at four time points, i.e. T1(baseline):immediately after anesthesia induction; and 1h,2h,4h after aorta declamping (T2, T3, T4). The serum concentrations of specific myocardial injury marker-troponin T were measured by electrochemil-uminescence. The serum concentrations of IL-6, L-8 were tested by radio-immunity. Results:1.There were no remarkable difference in age,sex,weight,preoperative EF,duration of operation,CPB and aorta occlusion between two groups(p>0.05).2. Comparing with baseline, serum concentration of troponin T, IL-6 and IL-8 increased markedly after aorta declamping (p<0.05) in both groups.3. No difference was observed in serum level of troponin T, IL-6 and IL-8 at T1 between the two groups(p>0.05). However, serum level of cTnT, IL-6 and IL-8 were significantly lower at T2,T3 and T4 (p<0.05) in sevoflurane group than in the control. Conclusion:1.The findings in the study revealed that sevoflurane postcondition-ing can remarkably lessen release of troponin T, which implies that myocardial ischemia/reperfusion injury may be attenuated by this clinical protocol.2. Sevoflurane postconditioning can simultaneously inhibit over expression or production of interleukin-6 and interleukin-8.3. The myocardial protection of sevoflurane postconditio-ning may be related to attenuation of systemic inflammatory response syndrome.