The serum levels of IL-8, IL-10, and TNF-a, cardiac troponin I, creatine kinase-MB in patients with rheumatic heart disease received dexmedetomidine.

IF 1.5 4区医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY

Journal of Medical Biochemistry Pub Date : 2025-08-21 DOI:10.5937/jomb0-56030

Dongmei Yang, Jian Zhang, Caiyun Zhang

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Abstract

Background: This study aimed to evaluate the effects of dexmedetomidine (DEX) in patients undergoing valve replacement surgery for rheumatic heart disease (RHD), focusing on its impact on serum levels of inflammatory markers (IL-8, IL-10, TNF-a) and myocardial injury markers (Cardiac Troponin I [cTnI], Creatine Kinase-MB [CK-MB]).

Methods: A total of 140 patients undergoing cardiopulmonary bypass (CPB) valve replacement surgery at West China Hospital, Sichuan University, between January 2022 and December 2024 were randomly assigned to two groups: the observation group (DEX) and the control group (normal saline). Key perioperative parameters were analysed, including anaesthetic dosage, myocardial injury markers, immune function (CD4+, CD8+, and CD4+/CD8+ ratio), inflammatory factors, and adverse reactions.

Results: The observation group required significantly lower anaesthetic dosages than the control group. Additionally, the observation group exhibited higher heart rate (HR) at T5 and higher mean arterial pressure (MAP) at T2, T3, and T5 (P< 0.05). Myocardial injury markers (cTnI and CK-MB) were significantly lower in the observation group (P< 0.05). While preoperative cellular immune function (CD4+, CD8+, and CD4+/CD8+) was similar between both groups, postoperative measurements showed significantly higher CD4+ and CD4+/CD8+ ratios, and lower CD8+ in the observation group (P < 0.05). Regarding inflammatory markers, IL-8 and TNF-a levels were significantly lower, while IL-10 was higher in the observation group postoperatively (P < 0 .0 5). There were no significant differences in adverse reactions between the two groups (P > 0 .0 5).

Conclusions: Dexmedetomidine (DEX) reduces anaesthetic usage, supports hemodynamic stability, mitigates myocardial injury, and lowers postoperative inflammatory responses in patients undergoing RHD valve replacement surgery.

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右美托咪定对风湿性心脏病患者血清IL-8、IL-10、TNF-a、心肌肌钙蛋白I、肌酸激酶mb水平的影响。

背景：本研究旨在评估右美托咪定（DEX）对风湿性心脏病（RHD）瓣膜置换术患者的影响，重点关注其对血清炎症标志物（IL-8、IL-10、TNF-a）和心肌损伤标志物（心肌肌钙蛋白I [cTnI]、肌酸激酶mb [CK-MB]）水平的影响。方法：选择2022年1月~ 2024年12月在四川大学华西医院行体外循环（CPB）瓣膜置换术的患者140例，随机分为观察组（DEX）和对照组（生理盐水）两组。分析围手术期关键参数，包括麻醉剂量、心肌损伤标志物、免疫功能（CD4+、CD8+、CD4+/CD8+比值）、炎症因子、不良反应等。结果：观察组麻醉剂量明显低于对照组。观察组患者T5时心率（HR）升高，T2、T3、T5时平均动脉压（MAP）升高（P< 0.05）。观察组大鼠心肌损伤标志物cTnI、CK-MB显著降低（P< 0.05）。两组患者术前细胞免疫功能（CD4+、CD8+、CD4+/CD8+）差异无统计学意义，术后观察组CD4+、CD4+/CD8+比值显著升高，CD8+明显降低（P < 0.05）。炎症标志物方面，观察组术后IL-8、TNF-a水平显著降低，IL-10水平显著升高（P < 0.05）。0 5)。两组患者不良反应发生率比较差异无统计学意义（P < 0.05）。0 5)。结论：右美托咪定（DEX）减少了RHD瓣膜置换术患者麻醉剂的使用，支持血流动力学稳定性，减轻心肌损伤，降低术后炎症反应。

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来源期刊

Journal of Medical Biochemistry BIOCHEMISTRY & MOLECULAR BIOLOGY-

CiteScore

3.00

自引率

12.00%

发文量

审稿时长

>12 weeks

期刊介绍： The JOURNAL OF MEDICAL BIOCHEMISTRY (J MED BIOCHEM) is the official journal of the Society of Medical Biochemists of Serbia with international peer-review. Papers are independently reviewed by at least two reviewers selected by the Editors as Blind Peer Reviews. The Journal of Medical Biochemistry is published quarterly. The Journal publishes original scientific and specialized articles on all aspects of clinical and medical biochemistry, molecular medicine, clinical hematology and coagulation, clinical immunology and autoimmunity, clinical microbiology, virology, clinical genomics and molecular biology, genetic epidemiology, drug measurement, evaluation of diagnostic markers, new reagents and laboratory equipment, reference materials and methods, reference values, laboratory organization, automation, quality control, clinical metrology, all related scientific disciplines where chemistry, biochemistry, molecular biology and immunochemistry deal with the study of normal and pathologic processes in human beings.