Study on the Relationship of APACHE III and Levels of Cytokines in Patients with Systemic Inflammatory Response Syndrome after Coronary Artery Bypass Grafting(Biochemistry)
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概要
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The aim of this study was to explore the relationship and interpret the clinical importance of acute physiology and chronic health evaluation III (APACHE III) and levels of cytokines in patients with systemic inflammatory response syndrome (SIRS) after coronary artery bypass grafting (CABG) with or without cardio-pulmonary bypass (CPB) to see if they are beneficial for evaluating the seriousness of SIRS. The data suggested that the APACHE III score and levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and soluble interleukin-2 receptor (slL-2R) were significantly higher after conventional CABG (CCABG) than after off-pump coronary artery bypass grafting (OPCAB) (p<0.05). With an increase in the APACHE III score, the levels of IL6, IL8, TNF-α; IL-1β, and sIL-2R and the morbidity of multiple organ dysfunction syndrome (MODS) increased gradually (p<0.01), while the level of IL2 decreased (p<0.01). Stepwise regression analysis showed that IL-lβ, IL6, IL8, and sIL-2R levels had significant influences on the APACHE III score (p<0.05). The APACHE III score and levels of IL6, IL8, TNF-α; IL-lβ, and sIL-2R were significantly higher in the MODS group than in the non-MODS group (p<0.05), but the level of IL2 was significantly lower in the MODS group (p=0.04). In conclusion, despite comparable surgical trauma, we believe that CPB is one of the most important factors responsible for stimulating an inflammatory response. SIRS after OPCAB was clearly mitigated compared with CCABG. Determination of the APACHE III score and plasma IL-lβ, IL6, IL8 and slL-2R concentrations might be helpful for evaluating the severity of SIRS following CABG and making a prognosis.
- 2007-03-01
著者
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Hu Dayi
中華人民共和国
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Feng Jing
Department of Thoracic Cardiovascular Surgery, Tongji Hospital, Tongji University
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MEI Yun
Heart-Lung-Blood Vessel Center of Tongji Universty, Institute of Heart-Lung-Blood Vessel Disease of
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JI Qiang
Heart-Lung-Blood Vessel Center of Tongji Universty, Institute of Heart-Lung-Blood Vessel Disease of
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LIU Hua
Division of Heart Surgery. Zhongshan Hospital. Fudan University
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WANG Xisheng
Heart-Lung-Blood Vessel Center of Tongji Universty, Institute of Heart-Lung-Blood Vessel Disease of
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FENG Jing
Heart-Lung-Blood Vessel Center of Tongji Universty, Institute of Heart-Lung-Blood Vessel Disease of
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LONG Cun
CPB Dept. of Fuwai Hospital, P.R.China
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CHENG Bangchang
Dept. of Thoraco-Cardiovascular Surgery of People's Hospital, Wuhan Universty
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XING Yan
Heart-Lung-Blood Vessel Center of Tongji Universty, Institute of Heart-Lung-Blood Vessel Disease of
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LI Jue
Heart-Lung-Blood Vessel Center of Tongji Universty, Institute of Heart-Lung-Blood Vessel Disease of
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HU Dayi
Heart-Lung-Blood Vessel Center of Tongji University, Institute of Heart-Lung-Blood Vessel Disease of
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Li Jue
Heart-lung-blood Vessel Center Of Tongji Universty Institute Of Heart-lung-blood Vessel Disease Of T
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Hu Dayi
Heart-lung-blood Vessel Center Of Tongji University Institute Of Heart-lung-blood Vessel Disease Of
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Hu Dayi
Department Of Cardiology People's Hospital Peking University
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Hu Dayi
Heart Center People's Hospital Of Peking University People's Republic Of China
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Mei Yun
Department Of Thoracic Cardiovascular Surgery Tongji Hospital
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Long Cun
Cpb Dept. Of Fuwai Hospital P.r.china
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Ji Qiang
Department Of Thoracic Cardiovascular Surgery Tongji Hospital
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Xing Yan
Heart-lung-blood Vessel Center Of Tongji Universty Institute Of Heart-lung-blood Vessel Disease Of T
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Wang Xisheng
Department Of Thoracic Cardiovascular Surgery Tongji Hospital
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Feng Jing
Department Of Thoracic Cardiovascular Surgery Tongji Hospital
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Cheng Bangchang
Dept. Of Thoraco-cardiovascular Surgery Of People's Hospital Wuhan Universty
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Li Jue
Heart Lung And Blood Vessel Center Of Tongji University
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Hu Dayi
The College Of Medicine Tongji University
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