Changes Of IL-6,IL-10,TNF-? In Fetal Sheep Myocardium After Fetal Sheep Cardiopulmonary Bypass

Objective To observe the changes of fetal blood gas and the expression of IL-6,IL-10,and TNF-a in the fetal heart of fetus during the peri-fetal phase of fetal goat circumstance by establishing fetal sheep cardiopulmonary bypass model,and to explore their effects on fetal sheep after cardiopulmonary bypass.Fetal sheep heart function mechanism.Methods Eight pregnant sheep(120-140 days of pregnancy)were randomly divided into control group and bypass group with 4 animals in each group.The control group received a midline incision in the lower abdomen of the pregnant sheep to expose the uterus.The uterus was then incised to expose the fetus and the upper limb of the fetus was incised.The iliac artery was placed into the trocar to detect changes in hemodynamic forces and blood samples were collected.The fetal sheep were placed in the thoracolumbar,the main pulmonary artery and the right atrium were cannulated,then the extracorporeal circulation tube and the blood reservoir were connected,and the extracorporeal circulation was established by using a centrifugal pump and the placenta(as the only oxygenator),and the flow was not observed for 3 hours.The sheep in the bypass group had the same treatment as the control group.The CPB1 h in the bypassgroup was observed for 2 hours after shutdown.The mean values of the fetal sheep before CPB(T0),CPB 30 min(T1),CPB 1h(T2),CPB 1h(T3),and CPB2 h(T4)were recorded.Arterial pressure,heart rate,and brachial blood gas results.The placental tissues of about 0.5x0.5x0.5cm in the heart of the fetal sheep before and 2 hours after the cardiopulmonary bypass of the control group and the bypass group were taken.Serum concentrations of IL-6,IL-10 and TNF-a were determined by enzyme-linked immunosorbent assay(ELISA).Paraffin immunohistochemistry was used to detect the expression levels of IL-6,IL-10 and TNF-? in the myocardial tissue of each group of fetal goats.The image-Pro Plus 6.O(IPP)color image analysis system was used to detect IL-6 in fetal heart muscle.IL-10,TNF-?expression was analyzed semi-quantitatively.Result 1.The heart rate,blood pressure and arterial blood gas value of the fetuses in the control group and the bypass group were changed during the whole experiment.There was no statistical significance in the group(p>0.05).There was statistical significance between the groups(P<O.05).).The heart rate(HR)and mean arterial pressure(MAP)of the fetuses in the bypass group first rose,then rose,and the arterial oxygen partial pressure(PaO2)decreased first and then increased,but there was no statistical significance(P>0.05).The arterial carbon dioxide partial pressure(PaCO2)and arterial blood lactate(Lactate)increased significantly and then decreased in the bypass group.The fetal hepatic arterial PH had a tendency to decrease first and then increase.The change was statistically significant.During the cardiopulmonary bypass,the PH of the fetal goat artery in the experimental group and the bypass group gradually decreased with time.After the CPB stopped,it reached the lowest value after 1h and then increased.However,the decrease and increase range of the control group and the transition group were different,and the amplitude of the transitiongroup was changed.Bigger.In the control group and bypass group,the fetal artery(PaCO2)first rose and then decreased with the experiment.After the CPB stopped,it reached the highest value and then began to decline after 1h.The control group and the transition group had different increases and decreases.The transition group The change is more pronounced.The Lactate in the fetus was also gradually increased and then decreased in the control group and the bypass group.The CPB peaked at 1h and then decreased,and the change in the transition group was greater.2.Compared with serum IL-6 and TNF-a at different phases,IL-6 and TNF-a levels in the transition group were significantly higher than those before CPB(T0)after CPB began(P < 0.05).At T0,there was no significant difference in IL-6 and TNF-a levels between the control group and the transflow group(P >0.05).At T1-T4,IL-6 and TNF-a levels were significantly higher in the transfluid group than in the control group.In the control group(P < 0.05),IL-6and TNF-a in the transition group first increased and then peaked at 1 h after CPB end and then decreased.Compared with serum IL-10 at different phases,IL-10 levels in the transition group were significantly higher than those before CPB(T0)after CPB began(P < 0.05).At T0,there was no significant difference in IL-10 level between the control group and the bypass group(P > 0.05).At T1-T4,the IL-10 level in the transition group was significantly higher than that of the control group(P < 0.05).),IL-10 in the transition group increased with time.3.The levels of IL-6 and TNF-a in the myocardial tissue of the fetus of the control group were low.The expression in the transflow group was significantly higher than that in the control group(P < 0.05).The expression of IL-6 and TNF-a was mainly distributed in the cell membrane and cytoplasm ofcardiomyocytes,interstitial fibroblasts,or brownish yellow or Yellow particles.IL-10 showed low or no expression in fetal sheep myocardial tissue.Conclusion The establishment of the fetal sheep cardiopulmonary bypass model has a significant impact on fetal heart function.Acidosis,hypoxia and hypercapnia,and hyperlactatemia occur after extracorporeal circulation of the fetus,resulting in both fetal heart rate and mean arterial pressure.decline.We speculate that abnormally elevated inflammatory factors are the main cause of myocardial damage in fetal sheep.This model can provide a certain experimental basis for the future application of fetal extracorporeal circulation technology to clinical application.IL-6 and TNF-a in fetal goat's myocardial tissue after extracorporeal circulation of fetal sheep The expression of IL-10 was significantly increased in the serum,and there was no significant expression of IL-10 in serum but serum levels were significantly increased.We speculated that IL-6 and TNF-a are mainly expressed in the myocardium and IL-10 is mainly in the myocardium.High expression of tissues or organs,three inflammatory factors may be involved in the fetal sheep cardiopulmonary bypass myocardial damage and protection of the physiological process of the case,we speculate that the three may form TNF-a/IL-6/IL-10 signaling pathway Induced damage and protection of fetal heart function after fetal extracorporeal circulation.