Investigation Of Changing Of Inflammatory Cytokine After CABG And Comparison Perioperative Of CABG Prophylaxis Use Of Three Kinds Of Antibiotics

Background:Myocardial ischemia-reperfusion injury associated with cardiac surgery is an acute inflammatory process in which activated leukocytes and endothelial cells play a critical role.Recent investigations have clearly shown that cytokines,a group of low-molecular weight polypeptides which function as intercellular communication molecules,play a central role in inflammatory reactions and particularly in inducing myocardial injury.The most studied pro-inflammatory cytokines include tumor necrosis factor(TNF-α),interleukin-6(IL-6),and interleukin-8(IL-8).Meanwhile,the important anti-inflammatory capacity of interleukin-10(IL-10)has also been widely known.To investigate the useage of antibiotics after coronary artery bypass graft.Objectives:1.to observe the changes of IL-6,IL-8,IL-10 in plasma before and after coronary artery bypass grafting(CABG), and discuss the correlations between the expression of inflammatory factor and postoperative organ functional disturbance.2.The tendency of the inflammation reaction of the patients after operation was primarily investigated and compared.To investigate the influence of different operation fashions on inflammation reaction,we compared difference in levels of inflammation reaction between the patients undertook the CABG with and without heart's beat-stopping condition.Methods: Blood samples were obtained from 98 patients before,and 1,4,24,72h after coronary artery bypass grafting.The plasma levels of IL-6,IL-8,IL-10 were measured by liquichip.Biochemistry index such as CKMB,ALT,AST,Hb were detected. Volume of blood loss,blood pressure and other clinical data were recorded throughout the perioperative period.Eight-four patients were divided into three groups;Mezlocillin group,Cefuroxime group and Ciprofloxacin group.Each group includes twenty-eight patients.We compared the cases that suffering infection, changes of body temperature and WBC level,cost of hospitalization after CABG.Results:1.The peak concentrations of IL-6,IL-8,IL-10 in plasma were achieved at 1h after cardiac surgery(IL-6:160.02[88.28-159.56],P＜0.01;IL-8. 18.91[9.32—27.78],P＜0.01;IL-10:16.44[8.59-21.90],P＜0.01)and were still increased at 72h after Cardiac Surgery.2.There were good correlations between IL-6, IL-8 and IL-10 in each time point.3.IL-6 were favorably correlated with at different time points(correlation coefficient r＞0.400)At one hour after the operation.The blood level of IL-10 in patients with the respiratory machine over 24 hours were significantly higher than that of those using the respiratory machine less than 24 hours.There were no differences in incidence of infection between three groups,the period which breathing machine is used and the cost of hospitalization were fewer in Cefuroxime group.Conclusion:1.CABG is associated with an acute inflammatory process which may persistence throughout the perioperative period.2. The pro-inflammatory cytokines and anti-inflammatory cytokines were increased after surgery,but it has no difference in inflammatory response between CABG and OPCABG.3.Inflammatory process is associated with the time which breathing machine is used.4.Inflammatory process is not associated with myocardial injury. The short-term use of Ciprofloxacin after CABG can prevent the patients from infection of CABG,and save medical resources.