The Association of Systemic Inflammatory Markers With Indicators of Stress and Cardiac Necrosis in Patients Undergoing Aortic Valve Replacement and Revascularization Surgeries
The Association of Systemic Inflammatory Markers With Indicators of Stress and Cardiac Necrosis in Patients Undergoing Aortic Valve Replacement and Revascularization Surgeries
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DOI：
10.33549/physiolres.934243
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发表时间：
2020-04-01
影响因子：
2.1
通讯作者：
Simundic, Ana-Maria
中科院分区：
文献类型：
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作者：
Saracevic, Andrea;Medved, Igor;Simundic, Ana-Maria
目的是调查：接受心脏直视手术患者术后5天内炎症、应激和心脏反应的变化；炎症、应激和心脏反应之间的关系，以及某一标志物的变化是否可以预测患者的短期预后。90例患者分为3组，每组30人（有泵、无泵血运重建术组和瓣膜置换术组）。测定全血细胞计数、CRP、IL-6、IL-10、瘦素、抵抗素、单核细胞趋化蛋白-1 （MCP-1）、皮质醇、CK、hsTnT 5个点的指标。抵抗素在三组中均有所增加。手术后，无泵组患者IL-10水平较低，而瘦素和MCP-1水平高于有泵组。停泵组术后IL-6、IL-10、瘦素、抵抗素、MCP-1水平高于开泵组，CK、hsTnT 24水平低于开泵组。我们发现MCP-1与抵抗素有显著相关性。时间点2和3抵抗素的差异显著预测了输血需求；而术前和术后CRP和抵抗素的差异以及术后和术后24小时白细胞的差异预测了肌力药物/血管加压药物的使用。心脏手术会导致炎症、压力和心脏标志物的增加。只有抵抗素与MCP-1相关，证实了浸润性巨噬细胞分泌抵抗素与MCP-1释放增强之间的联系。
The aim was to investigate: changes of inflammatory, stress and cardiac response in patients undergoing open heart surgeries up to five days after the procedure; the association between inflammatory, stress and cardiac response and whether changes in a certain marker can predict short-term patient outcome. Ninety patients were divided into three groups, 30 participants each (on-pump, off-pump revascularization and valve replacement group). The following markers were measured: complete blood count, CRP, IL-6, IL-10, leptin, resistin, monocyte chemoattractant protein-1 (MCP-1), cortisol, CK and hsTnT in 5 points. Resistin increased in all three groups. Lower IL-10 levels were found after the surgery and higher levels of leptin and MCP-1 in the off-pump than in the on-pump group. Off-pump group had higher values of IL-6, IL-10, leptin, resistin and MCP-1 and lower levels of CK and hsTnT 24 after surgery than the on-pump group. We found significant correlation between MCP-1 and resistin. The difference between resistin at time points 2 and 3 significantly predicted transfusion needs; while the difference between CRP and resistin before and at the end of the surgery together with the difference between leukocytes at the end and 24 hours after the surgery predicted the use of inotropic agents/vasopressors. Cardiac surgeries cause an increase of inflammatory, stress and cardiac markers. Only resistin correlated with MCP-1 which confirms the link between resistin secreted form infiltrated macrophages and enhanced release of MCP-1.