Prostaglandin E1 reduces myocardial reperfusion injury by inhibiting proinflammatory cytokines production during cardiac surgery
Prostaglandin E1 reduces myocardial reperfusion injury by inhibiting proinflammatory cytokines production during cardiac surgery
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DOI：
10.1097/00003246-200007000-00004
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发表时间：
2000-07-01
影响因子：
8.8
通讯作者：
Endo, S
中科院分区：
文献类型：
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作者：
Kawamura, T;Nara, N;Endo, S
目的：探讨前列腺素E-1(PGE)在心脏手术中对细胞因子平衡和心肌保护的影响。设计：前瞻性、随机、非盲法研究。对象：19例体外循环心脏手术患者。干预：按随机顺序，从手术开始到研究结束(PGE组，n=11)或不给予PGE(0.02，相当于0.05µg·kg(-1)min(-1))。检测方法及主要结果：采用双抗体夹心酶联免疫吸附试验检测白细胞介素6、8、10、L受体拮抗剂、可溶性肿瘤坏死因子受体I、可溶性肿瘤坏死因子受体II。肌钙蛋白T测定采用酶免疫法，肌酸激酶肌酸激酶同工酶(CK-MB)测定采用分光光度法。两组患者的血清IL-6和IL-8浓度均较术前显著升高(P<0.01)，但对照组的升高幅度大于PGE(1)组(P<；0.01)。两组患者的血清IL-10、IL-1ra、sTNFRI和sTNFRII浓度在开放主动脉后60min较术前显著升高(p<；.001)。两组之间没有差异。两组的血清肌钙蛋白T和CK-MB浓度在开放主动脉后60分钟开始显著升高(P<；.001)，但对照组的升高幅度大于PGE组(P<；.01)。IL-6和IL-8水平与CK-MB浓度呈正相关(r(2)=0.49，r(2)=0.36；p>；.001)。结论：PGE(1)可抑制IL-6和IL-8的产生，但不抑制IL-10、IL-1ra、sTNF RI和sTNF RII的产生。促炎和抗炎细胞因子平衡的改变可能是PGE，最重要的细胞保护机制之一。
Objective: To determine the influence of prostaglandin E-1 (PGE,) on the cytokine balance and myocardial protection during cardiac surgery.Design: Prospective, randomized, nonblinded study.Setting University hospital.Patients: A total of 19 patients on cardiopulmonary bypass undergoing cardiac surgery.Interventions: According to randomized sequence, the patients received PGE(1) (0.02 similar to 0.05 mu g.kg(-1) min(-1)) from the beginning of surgery to the end of study (PGE, group, n = 11) or nothing (control group, n = 8).Measurements and Main Results: Interleukin (IL)-6, IL-8, IL-10, IL-l receptor antagonist (IL-1ra), soluble tumor necrosis factor receptor I (sTNF RI), and soluble tumor necrosis factor receptor II (sTNf RII) were measured by enzyme-linked immunosorbent assays. Troponin-T and isoenzyme of creatine kinase with muscle and brain subunits (CK-MB) were measured by enzyme immunoassay and ultraviolet absorption spectrophotometry method, respectively. Serum IL-6 and IL-8 concentrations in both groups increased significantly from 60 mins after declamping the aorta compared with preoperative value (p < .001), However, the increases were greater in the control group than in the PGE(1) group (p < .01). Serum IL-10, IL-1ra, sTNF RI, and sTNF RII concentrations increased significantly from 60 mins after declamping the aorta compared with preoperative values in two groups (p < .001, respectively). There were no differences between the two groups. Serum troponin T and CK-MB concentrations increased significantly in the two groups from 60 mins after declamping the aorta (p < .001), but these increases were greater in the control group than in the PGE, group (P < .01). IL-6 and IL-8 levels correlated with CK-MB concentration (r(2) = 0.49, r(2) = 0.36; p > .001 respectively).Conclusions: PGE(1) suppressed the production of IL-6 and IL-8 but not IL-10, IL-1ra, sTNF RI, or sTNF RII. The change in the balance between pro-and anti-inflammatory cytokines may be one of the most important cytoprotective mechanisms of PGE,.