A Study Of The Perioperative Changes Of Cytokine Levels In Coronary Artery Bypass Grafting

Objective:Coronary artery bypass surgery frequently accompanied by acute inflammatory reaction, in which inflammatory factors and endothelial cells play an important role. As a group of low molecular weight peptides with the function of intercellular communication, inflammatory factors influence the postoperative inflammatory response. It's the pro-inflammatory-anti-inflammatory homeostatic imbalance between anti-inflammatory factors and inflammatory cytokines which cause inflammation of myocardial injury and multiple organ dysfunctions. TNF-α, IL-6, IL-8 are the major inflammatory factor, and IL-10 is major anti-inflammatory factor. The study of the expression of inflammatory factors after operation will be helpful to prevent the postoperative organ damage. The purpose of this research is to study the relationship between the changes of inflammatory factors and postoperative multiple organ dysfunction, to investigate the pro-inflammatory-anti-inflammatory imbalance after open heart surgery, and the clinical application of liquid-chip.Methods:98 patients undergoing coronary artery bypass grafting were randomly selected. The level of IL-6, IL-8, IL-10 and TNF-a in plasma were tested by liquid-phase protein chip (before surgery, lhr,4 hrs,24rs and 72 hrs after operation). Postoperative blood pressure, heart rate, body temperature and other vital life-sign were monitored. The clinical data were compared and analyzed with statistical software.Results:There is no significant difference of inflammatory reaction in the patients underwent traditional CABG or OPCABG. IL-6, IL-8, IL-10 levels were significantly higher than that before surgery, arrived peak 1 hr after operation (IL-6:160.02 [88.28-159.56], P=0.00; IL-8:18.91 [9.32-27.78], P=0.00; IL10:16.44 [8.59-21.90], P=0.00), drop down to preoperative levels 72 hrs after operation, whereas the level of TNF-αhad an opposite result.1 hr after operation, the level of IL-10/ (IL-6+IL-8+IL-10) was significantly increased in the group of ventilation support time>24hrs, comparing with the group of ventilation support time<24hrs (P=0.01). Conclusion:Acute postoperative inflammatory reaction can be observed in the patients after CABG and it can last for a time. Compared with the preoperative data, the levels of inflammatory factors were significantly elevated after operation. There is no significant difference in the expression of inflammatory cytokines between traditional CABG and OPCABG. Inflammatory balance was relevant to the postoperative mechanical ventilation support time.