前瞻性地重新评估促炎因子与泵上心脏手术后预后之间的关系

IF 0.5 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Yingting Huang, Xunbei Huang, Liqin Ling, Chaonan Liu, Si Chen, Jing Zhou, Lei Du, Jiyue Xiong
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引用次数: 0

摘要

目的:血浆中促炎症因子水平升高与体外循环心脏手术后预后恶化有关,但降低患者体内促炎症因子水平的干预措施未能改善预后。因此,我们探讨了促炎因子水平是否与心肺旁路瓣膜手术后患者的预后有关。在心肺旁路术前和术后多次测量肿瘤坏死因子(TNF)-α、白细胞介素-8和中性粒细胞弹性蛋白酶的水平。对是否发生院内不良事件的患者以及是否在三年随访期间发生重大心脏或脑血管不良事件(MACCE)的患者进行了水平比较:在 244 名入选患者中,有 38 人(15.6%)发生了院内不良事件;在 237 名完成随访的患者中,有 30 人(12.7%)发生了重大心脑血管不良事件。手术导致所有三种促炎症因子的水平明显升高,在到达重症监护室(TNF-α)、到达重症监护室后 4 小时(白细胞介素-8)或到达重症监护室后 20 小时(中性粒细胞弹性蛋白酶),这三种促炎症因子的水平均恢复到搭桥前的基线。然而,这三种因子在搭桥前和搭桥后的水平在是否在院内发生不良事件的患者之间,或在是否在随访期间发生澳门巴黎人娱乐官网的患者之间并无显著差异:TNF-α、白细胞介素-8和中性粒细胞弹性蛋白酶的水平可能与心肺搭桥术后的不良预后无关。结论:TNF-α、白细胞介素-8和中性粒细胞弹性蛋白酶的水平可能与心肺旁路术后的不良预后无关,这可能有助于解释为什么 "细胞因子清除 "策略无法改善泵上心脏手术后的临床预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prospective Reassessment of the Association Between Pro-Inflammatory Factors and Prognosis After on-Pump Cardiac Surgery.

Aim: Elevated levels of pro-inflammatory factors in plasma have been linked to worse prognosis after on-pump cardiac surgery, yet interventions that reduce the levels in patients have failed to improve prognosis. Therefore, we explored whether levels of pro-inflammatory factors are associated with prognosis of patients after valve surgery with cardiopulmonary bypass.

Material and methods: 244 patients were prospectively enrolled into observational study. Levels of tumor necrosis factor (TNF) - α, interleukin-8 and neutrophil elastase were measured once before and several times after cardiopulmonary bypass. The levels were compared between patients who experienced in-hospital adverse events or not, and between patients who experienced major adverse cardiac or cerebrovascular events (MACCEs) during three-year follow-up or not.

Results: Of the 244 patients enrolled, in-hospital adverse events occurred in 38 (15.6 %); of the 237 patients who completed follow-up, MACCEs occurred in 30 (12.7 %). Surgery led to significant increases in levels of all three pro-inflammatory factors, with levels returning to pre-bypass baseline on arrival in the intensive care unit (TNF-α), 4 h after arrival (interleukin-8) or 20 h after arrival (neutrophil elastase). However, pre- and post-bypass levels of all three factors did not differ significantly between patients who experienced adverse events in-hospital or not, or between patients who experienced MACCEs during follow-up or not.

Conclusions: Levels of TNF-α, interleukin-8 and neutrophil elastase may not be associated with poor prognosis after cardiopulmonary bypass. This may help explain why "cytokine clearance" strategies fail to improve clinical outcomes after on-pump cardiac surgery.

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来源期刊
Kardiologiya
Kardiologiya 医学-心血管系统
CiteScore
1.70
自引率
20.00%
发文量
94
审稿时长
3-8 weeks
期刊介绍: “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.
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