Changes Of Cytokines And Renal Function In Elderly During Upper Abdomen Surgery And Protection Of Methylprednisolone On Their Renal Function Impairment

PartⅠChanges of cytokines and renal function in elderly patients during upper abdomen surgeryObjective To observe the changes of cytokines and renal function in elderly patients during upper abdomen surgery compared with young adults and investigate the relationship between perioperative inflammation and renal injury. Methods 40 patients with electived surgery for gastric carcinoma under general anesthesia induced with fentanyl 0.2~0.4μg.kg-1, propofol 2mg.kg-1, rocuronium 50mg were divided into two groups: groupⅠpatients aged 65 years or older (N=20), and group II younger than 60 years (N=20). Anesthesia was maintained with isoflurane-N2O-vecuronium in two groups. Blood samples were analyzed for tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-10(IL-10), soluble TNF receptor-Ⅰ(sTNF-RⅠ), serum creatinine(Cr), blood urea nitrogen(BUN) and urine for urinaryα1-micro globulin(α1-MG), albumin(Alb),β-N-acetyl-D-glucosamini dase (NAG) before general anesthesia induction (T0),1h after incision (T1), on the first (T2), third (T3)and fifth day (T4) postoperatively. Results Plasma concentrations of TNF-αrose significantly at T1 and then returned to normal without difference between groups. Plasma concentrations of sTNF-RⅠr ose significantly from T1 to T4 without difference between groups. Plasma concentrations of interleukin-6 (IL-6) at T2 and T3 in elderly patients were significantly higher than those of young adults (p<0.05). Serum...