The Clinical Research About The Change Of Leptin And Cytokines In Infants Undergoing Major Surgery

The human response to surgical stress is characterized by a series of inflammatory, hormonal, and metabolic changes that together constitute the global stress response. Although it is clear that activation of the hypothalamo-pituitary-adrenocortical (HPA) axis is essential for the response for surgery, excessive activity may be detrimental .The purpose of this study was to characterize the dynamics of circulating leptin in relation to the acute activation of the HPA axis in infants undergoing majory surgery. We also studied the production patterns of Thl and Th2 cytokines following major surgery.Part I: The clinical research about the change of leptin in infants undergoing major surgeryObjective: To observe the change of leptin level in infants undergoing major surgery and to understand its roles. Methods: Seventeen infants(9 boys 8 girls) with congenital heart defects(n=10) and choledocele(n=2) and congenital Hirschsprung's disease(n=4) and congenital malformations of the anus and rectum(n=l).The age rangedThe Clinical Research About The Change Of Luptin And Cy told ties In Infants Lndergning Major Surgery Abstractfrom 4 months to 3 years.In accordance with the score standard of operation stress.We detected the serum level of leptin ,cortisol,and IGF-1 in preoperation,operation,postoperation and compared the change among them. Results: The serum level of leptin decreased sharply in operation,consequently increased to the base line,and came to normal in 24 hours after operation;The serum level of cortisol increased in operation and postoperation,and still higher than normal in 48 hours after operation. The serum level of IGF-1 increased in operation and postoperation,24 hours after operation IGF-1 was down to the baseline. Conclusion: Leptin play a role in stress response induced by surgery.In the early phase of operation stress,the decrease of leptin and the increase of cortisol was paralleled.