Time course of cytokine release and complement activation after implantation of the HeartMate left ventricular assist device
Time course of cytokine release and complement activation after implantation of the HeartMate left ventricular assist device
复制标题
DOI：
10.1097/00002480-199809000-00005
复制
发表时间：
1998-09-01
期刊：
影响因子：
4.2
通讯作者：
Richenbacher, WE
中科院分区：
文献类型：
--
作者：
Corry, DC;DeLucia, A;Richenbacher, WE
促炎介质，包括白细胞介素-6（IL-6）、IL-8和补体C3 a，在心脏手术后释放，作为与心肺转流回路中血液-生物材料相互作用相关的炎症反应的一部分。在接受左心室辅助装置（LVAD）支持的患者中，这些介质的术后时程数据尚未完全确定。作者在以下时间对6名HeartMate（R）LVAD接受者的血浆中IL-6、IL-8和C3 a浓度进行了酶联免疫吸附测定：术前;术后4、8、16、24、36和48小时;第一周每天;此后每周一次，持续6周。所有患者在研究期间均存活，无重大并发症。与年龄匹配的对照组相比，术前血浆中IL-6和C3 a的浓度显著升高。术后，插入LVAD后血浆中IL-6和IL-8浓度恢复至基线值所需的时间长于文献中报告的仅常规体外循环后的趋势。术后IL-6和补体C3 a的浓度继续降低至低于基线，在LVAD支持6周后达到统计学显著性。作者得出结论，与单独常规体外循环相比，HeartMate LVAD的存在延迟了促炎介质浓度恢复至基线值，但该器械似乎不是细胞因子释放或补体激活的持续来源。
Pro-inflammatory mediators, including interleukin-6 (IL-6), IL-8, and complement C3a, are released after cardiac surgery as part of the inflammatory response related to blood-biomaterial interaction in the cardiopulmonary bypass circuit. Post operative time course data for these mediators are not fully defined in patients receiving left ventricular assist device (LVAD) support. The authors performed enzyme linked immunosorbent assays for concentrations of IL-6, IL-8, and C3a in plasma in six HeartMate(R) LVAD recipients at the following times: pre operatively; 4, 8, 16, 24, 36, and 48 hr post operatively; daily through the first week; and weekly thereafter for 6 weeks. All patients survived without major complications during the study. Pre operative concentrations of IL-6 and C3a in plasma were significantly increased compared with age matched controls. Post operatively, the concentrations of IL-6 and IL-8 in plasma took longer to return to baseline values after insertion of the LVAD than the trends reported in the literature after routine cardiopulmonary bypass alone. Concentrations of IL-6 and complement C3a continued to decrease to lower than baseline post operatively, reaching statistical significance after 6 weeks of LVAD support. The authors conclude that the presence of the HeartMate LVAD delays the return of pro-inflammatory mediator concentrations back to baseline values compared with routine cardiopulmonary bypass alone, but the device does not appear to be an ongoing source of cytokine release or complement activation.