| With the improvement of facilities in cardiopulmonary bypass (CPB) and elevation of technology in operations, there is a significant decrease on the mortality of infants and children under open-heart surgery. But some of them died because of severe pulmonary complications. CPB can induce the retention of inflammatory cells in lung, then cause the pulmonary inflammatory diseases and airway hyperresponsiveness (AHR).So it's necessary to study the local immune state in lung. The variety of components in bronchoalveolar lavage fluid (BALF) doesn't consistent with that in blood. The analyse of BALF can clue to the local immunity and pathology in lung . There's important clinic significance to study the cytokines of BALF in children with congenital heart diseases(CHD). To elevate the airway response through the measuration of sICAM-1 and IL-8 in BALF have not been reported.ObjectiveIn this investigation the dynamic variety of sICAM-1 and IL-8 of BALF in children under open-heart operation has been studied by ELISA. The effects of CPB and pulmonary hypertension(PH) on sICAM-1 IL-8 in lung werestudied. It can provide valuable and sensitive signs to monitor AHR in clinic.SubjectsI Cardiopulmonary bypass group(CPB group): Thirty-four children with CHD who had been performed elective operation under CPB from March to June 2003 in the department of cardiovascular surgery, children's hospital of ZheJiang University were included in this study. Two groups had been separated by the pulmonary arterial pressure:(1)mormal pulmonary arterial pressure group(Non-PH group): Fourteen patients were male, and eleven were female. Mean age was 32.40 23.71 ( range 4-76 ) months old, and mean weight was 12.4014.94 ( range7-24 ) kg;(2)pulmonary hypertension group(PH group): Six patients were male, and three were female. Mean age was 30.67116.10 ( range 12-60) months old, and mean weight was 11.7813.64 (range 6-17) kg;II Non-cardiopulmonary bypass group (Non-CPB group) : Twenty children who had been performed elective operation without CPB at the same days were taken as controls. Eleven patients were male, and nine were female. Mean age was 29.45 19.03 ( range 6-84 ) months old, and mean weight was 14.8714.89 ( range 5-23 ) kg.None of the patients had clinical evidence of acute infection or underlying immune disease, and none were prescribed drug know to interfere with immune response before operation. There was no statistical difference of sex, weight and age between CPB group and Non-CPB group.MethodsThe BLAF samples were taken at three various time points (preoperative, 2-3and 72 hours postoperative) in CPB group, while samples were taken at two various time points (preoperative, 2-3 hours postoperative) in Non-CPB group. The expression of IL-8 and sICAM-1 were measured by EASIA and ELISA respectively. AH data were analyzed by SPSS for windows software.Results1. The percentages of eosinophil(10.92 2.59) and neutrophil(l 1.56 2.69) in PH group were higher than the Non-PH group (5.43 1.36, 6.37 1.41) and Non-CPB group(2.16 0.27, 3.56?.48)(P<0.01);2. The comparison of sICAM-1 (ng/ml) level in various time points in three groups:The expression of sICAM-1 at preoperative in PH group were significantly higher than Non-PH group (148.01 39.57 vs 86.44 15.80, P <0.01) and Non-CPB group (148.01 39.57 vs 87.07 20.11, P <0.01). At 2-3 hours postoperative, it was significantly higher in CPB group than Non-CPB group (P <0.01); it was significantly higher in PH group than the Non-PH group (220.54 38.25 vs 175.97 33.10 P <0.01). At 24 hours postoperative, it was significantly higher in PH group than the Non-PH group (251.31 42.26 vs 148.20 27.61, P<0.01). In the PH group, the postoperative sICAM-1 levels were higher than that preoperative.3. The comparison of IL-8 level in various time points in three groups:The expression of IL-8 at preoperative in PH group were significantly higher than Non-PH group (106.18 20.82 vs 44.01 15.92, P <0.01) and Non-CPBgroup (106.18 + 20.82 vs 38...
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