Dynamic Study Of Inflammatory Cytokine In Patients With Coronary Artery Bypass Grafting During Perioperation

Objective: To observe the level of inflammatary cytokines in patients with coronary heart disease. To find the dynamic change of cytokines in Coronary Artery Bypass Grafting during perioperation, and to compare the released extent of inflammatary cytokine and myocardial injury degree between coronary artery bypass grafting with cardiopulmonary bypass and off-pump coronary artery bypass grafting. Methods: Eighty-six patients with coronary artery who were isolated elective CABG operations were randomized into group 1 (off-pump CABG, n=73) and group2 (on-pump CABG, n=13) .In two groups, the samples were taken at preoperation,and at 1,4,24 and 72hours after surgery. Biochemical markers of myocardial injury(CKMB and TNI) were measured perioperatively. Plasma levels of TNF-a, IL 6, IL-8, and IL-10 were detected by the liquidchip technique.Results: IL-8 and TNFa in patients with CHD were significantly increased than that in control group (p<0.05), IL-6 and IL-10 in patients with CHD were increased than that incontrol group(p>0.05), There were no statistically significant differences between the two groups. The levels of IL-6, IL-8, IL-10 and TNFa showed dynamic change in CABG during perioperation. In comparison with the preoperative values, plasma levels of IL-6, IL-8, and IL-10 increased significantly after CABG and this lasted during the study period. Concentrations of IL-6, IL-10 and IL-8 reached the peak value at 1 h after CPB and started to decline afterward. The levels of IL-6, IL-8 and IL-10 didn't returned to preoperative levels at 72 hour(p<0.05). TNFa showed a slightly decreased at 1 hour and reach the bottom at 24 hour after surgery, it returned to preoperative levels at 72 hours (p>0.05). There was no significant difference between two groups preoperatively, In the CPB group, the increase of IL-6, IL-8, and IL-10 were greater than that in the off- pump group at lhour and at 4 hour . For IL-6, a strong increased was observed at 1hour, 4hour and 24hour aftersurgery(p=0.049, p=0.034, p=0.007);a similar response was observed for IL-8 and IL-10, with increased values for group 2 starting at 1 hours after surgery and a continuous elevation for the whole postopera -tive period. Compared with group 1, groups 2 showed a statistically significant elevation at 1 and 4 hours after surgery (p=0.049, p=0.040;p=0.046, p=0.049). There was only one statistically significant difference for TNFa when comparing group 1 with group 2;this difference was for the 4-hour postoperative sample (p=0.003).The value of CKMB and TNI after surgery in group 2 was significantly higher than that values in group 1( p=0.000, p=0.035, p=0.029;p=0.000, p=0.000, p=0.000).Conclusions: l.The levels of IL-8 and TNFa in patients with CHD were significantly increased than that in control group. 2.The inflammation cytokine show dynamic change in Coronary Artery Bypass Grafting during Perioperation.3. The release of IL-6JL-8 and IL-10 is enhanced by the use of CPB during various perioperative and postoperative phases. Intensity of the inflammatory response with CPB showed more stronger than that with off-pump CABG. It indicated slight myocardial injury in off-pump CABG after surgery.