The Correlations Of Perioperative Serum Catecholamines And Cytokines Level In Patients Undergoing Hepalobectomy

Objectives:The purpose of this topic is to investigate the correlations of perioperative serum catecholamines (E, NE) and cytokines TNF-α, IL-6 level in patients undergoing hepalobectomy, and it may prompt that catecholamines play a critical role in controlling inflammations.Methods:Find twenty patients who need hepalobectomy and have no other systemic diseases (ASA gradeⅡ～Ⅲ, NYHA gradeⅠ～Ⅱ). Exclusion criteria were as follows:patients with acute infections, rheumatoid activity and blood, endocrine, immune system diseases, signs of significant liver or renal function failure, hypertension, coronary artery disease, or carrying human immunodeficiency virus were not enrolled into the study. Patients treated with immune modulators (cytostatic drugs, corticosteroids) or alpha or beta receptor blocker or statins within 1 month before surgery or received epinephrine and norepinephrine during the operation were also excluded. Blood samples were taken from radial artery at the time-points of before anesthesia (T0),5min after cutting skin (T1),30min after recuperating liver blood flow (T2), 1h (T3),24h (T4) after operation, then the concentrations of E, NE, TNF-α, IL-6 were measured separately.Results: The serum concentrations of E, NE, TNF-αand IL-6 changed similarly during hepalobectomy, increased significantly at 5min after cutting skin (T1),30min after recuperating liver blood flow (T2), 1h (T3) and 24h (T4) after operation compared with the value before anesthesia (T0) (P<0.01), and peaked at 30min after recuperating liver blood flow (T2). After 24h of the operation, the levels decreased slightly. Spearman correlation analysis demonstrated that there was a positive relationship between E and pro-inflammatory cytokines TNF-α(P<0.05), IL-6 (P<0.05), and NE was also positively correlated with TNF-α(P< 0.01), IL-6 (P< 0.05).Conclusion:Tissual lesion and ischemic reperfusion injury of liver lead to a significant pro-inflammatory response and peaked at 30min after recuperating liver blood flow (T2). Catecholamines E and NE were positively correlated with pro-inflammatory cytokines TNF-αand IL-6 during operation. It can imply that catecholamines may exert pro-inflammatory effects though regulating the release of cytokines. This might be one of possible mechanisms of systemic inflammatory response (SIR).