Changes Of Plasma Interleukin-6, Soluble Intercellular Adhesion Molecules-1 And Atrial Natriuretic Peptide After Open Heart Surgery With Cardiopulmonary Bypass

Objective: The research was designed to observe the changes of plasma interleukin-6 (IL-6), soluble intercellular adhesion molecules-1 (sICAM-1) and atrial natriuretic peptide (ANP) after open heart surgery with cardiopulmonary bypass (CPB), and to explore the role of ANP and DL-6, sICAM-1 and the possible relationship between them around CPB.Methods: Twenty patients undergone cardiac operation with CPB and ten patients undergone thoractomy from Jul.2003 to Dec.2003 were selected in this study. Among cases with CPB it included ten patients among congenital heart disease (CHD) group for atrioseptopexy or ventricoseptopexy and ten among reuhmatic heart diease (RHD) group for mitral valve replacement (MVR), aortic valve replacement (AYR) or dual valve replacements (DVR). Of the contrast, thoracic group, it included patients undergone lobectomy (LE) or esophagectomy (EE). Plasma concentration of IL-6, sICAM-1 and ANP were measured with enzyme-linked immunosorbent assays and radioimmunity methods at the following time points: during anethetic induction period, before the remove of the aortic clamp, the end of CPB, 6, 24, 48, 72 hours after the termination of CPB. For the contrast the measuring point was during anethetic induction period, the end of the single-lung ventilation, the end of operation, 6, 24, 48, 72 hours after operation. HCT were recorded simultaneously with blood sampling.Results: Plasma concentration of IL-6, sICAM-1 and ANPIL-6 In all groups it can be observed that plasma concentration of IL-6 intraoperation and postoperation is higher than that in anethetic induction period obviously, and at the point of the 6-hour after operation it get to peak. For cases with CPB plasma concentration of IL-6 in RHD group is higher than that in CHD group at the point of before the remove of the aortic clamp, the end of CPB, 6, 24, 48, 72 hours after the termination of CPB.sICAM-l In thoracic group there is no no obvious difference of concentration of plasma sICAM-l between the various measuring point. For cases with CPB plasma concentration of sICAM-l intraoperation and at the point of the 6-hour after operation is higher than that in anethetic induction period obviously, and at the point of the 6-hour after operation it get to peak. As well as IL-6, in the CPB group plasma concentration of sICAM-l is higher than that in CHD group at the point of before the remove of the aortic clamp, the end of CPB, 6, 24,48,72 hours after the termination of CPB.ANP In thoracic group there is no no obvious difference of concentration of plasma ANP between the various measuring point. For cases with CPB concentration of plasma ANP goes up with operation undergoing, and at the end of CPB it get to peak. In CHD group plasma concentration of ANP is higher than that in anethetic induction period obviously at the point of before the remove of the aortic clamp, the end of CPB, 6,24 hours after the termination of CPB; and is lower than that in anethetic induction period obviously at the point of 72 hours after the termination of CPB. In RHD group plasma concentration of ANP is higher than that in anethetic induction period obviously at the point of before the remove of the aortic clamp, the end of CPB; and is lower than that in anethetic induction period obviously at the point of 24, 48, 72 hours after the termination of CPB. Comparing with CHD group plasma concentration of ANP in RHD group is higher at the point of during anethetic induction period, before the remove of the aortic clamp, the end of CPB, 6, 24, 48 hours after the termination of CPB, and lower at the point of 72 hours after the termination of CPB.Correlation between period of CPB and IL-6, sICAM-l, ANPThere was a significant correlation between duruation of cross-clampping and concentration of IL-6 ( for CHD r = 0.876, p<0.01; for RHD r = 0.963, p<0.01 ), sICAM-l ( for CHD r =0.939, p<0.01; for RHD r = 0.58, p<0.01 ) at the point of 6 hours after the termination of CPB; and between duruation of CPB and concentration of ANP ( for CHD r =0.888, p<0.01 ; for RHD r...