| BackgroundCardiac surgery with cardiopulmonary bypass(CPB)provokes a syste-mic inflammatory response by the activation of inflammatory cells and body fluid co -mponents.Contact of the blood components with the artificial surface of the bypass circuit,ischemia-reperfusion injury,endotoxemia and operative trauma are all possi -ble causes.This inflammatory reaction may contribute to the development of posto -perative complications,including acute pulmonary injury,myocardial dysfunction, brain injury,renal dysfunction,and postoperative infection.Therefore,it is of crucial importance to prevent and treat the inflammatory reaction for reducing postoperative complications,improving surgical outcome,and decreasing medical cost.Ligustrazine is one of the active ingredients contained in Ligusticum chuanxiong Hort.It is able to protect vascular endothelial cells and lower blood pressure;change red blood cell's rheological properties,decrease blood stasis,inhibit platelet aggregation,and improve the micro-circulation;eliminate oxygen free radicals,exhibit anti-lipid peroxidation and calcium-antagonistic effects,and protect against ischemia-reperfusion injury; affect the expression of cytokines and cell adhesion molecules with anti-inflammation effect.Ligustrazine is widely used in traditional Chinese medicine for the treatment of cardiovascular,brain,renal and pulmonary diseases.This study was to detect the expr -ession of neutrophil CD11b/CD18 adhesion molecules in infants during CPB openheart surgery by flow cytometry.The blood levels of IL-6 and IL-8 were measured by a double antigens sandwich Enzyme-Linked ImmunoSorbent Assay(ELISA).The eff -ect of ligustrazine was dynamically monitored and compared with controls.The study aimed to investigate the effect of ligustrazine on inflammatory reaction in pediatric patients with CPB open-heart surgery.MethodsForty-seven patients with congenital heart disease(CHD)were randomly divided into two groups for surgery.The intervention group received Ligustrazine Hu -drochloride of 5 mg/kg in the CPB prime solution,while the control group without. Three milliliters of blood sample was taken from radial artery at induction of anaesthe -sia,20 minutes after CPB,termination of surgery,6 hours after surgery,and 24 hours after surgery,respectively.Of the blood sample,0.5 ml was used to detect the expression of neutrophil CD11b/CD18 expression by flow cytometry,and 2.5 ml was used to detect the IL-6 and IL-8 levels of by ELISA.SPSS11.5 was used for statistical analysis.Results 1)After induction of anaesthesia,there is no significant difference between the two groups in neutrophil CD11b/CD18 expression and IL-6 and IL-8 levels(P＞0.05). Baseline was settled at this time point.2)Changes of CD11b/CD18 expression:The levels of CD11b/CD 18 expression were significantly lower in the intervention group than in control group at 20 minutes after CPB,termination of surgery,and 6 hours after surgery(P＜0.05).But such difference was not observed at 24 hours after surgery(P＞0.05).3)Changes of IL-6 levels:The levels of IL-6 levels were significantly higher and get -ting to the peak in both groups at 6 hours after surgery.But IL-6 levels were increased lower in the intervention group,significantly lower at 6 hours(P＜0.05)and 1 day after surgery(P＜0.01)than the control group.4)Changes of IL-8 levels:IL-8 levels were significantly lower in the intervention group than in the control group at 20 minutes after CPB(P＜0.05),termination of surgery(P＜0.01),and 6 hours after surgery(P＜0.05).But no significant difference was observed at 1 day after surgery between the two groups.ConclusionsLigustrazine Hudrochloride is found to be able to decrease the expression of neutrophil CD11b/CD18 molecules in CPB open-heart surgery and lower IL-6 and IL-8 levels,so as to diminish the inflammatory reaction in CPB open-heart surgery. |
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