ABSTRACT
Objective To investigate the change of cardiac troponin Ⅰ (cTn Ⅰ),interleukin (IL)-6 in patients undergoing cardiac valve replacement and compare the degrees of fentanil,sufentanil,and remifentanil on myocardial protection and inhibiting effect of inflammatory.Methods Forty-eight patients,undergoing cardiac valve replacement,were randomly divided into three groups (n =16):remifentanil (group R),sufentanil (group S),and fentanil (group F).All the patients were total intravenous anesthesia of midazolam,opioid,vecuronim,and propofol.Different opioids were used in each group.Group R was induced with remifentanyl 1 ～2 μg/kg and maintained at a rate of 1 ～4 μg/(kg · min).Group S was induced with sufentanyl 1 ～2 μg/kg and maintained at a rate of 1 ～4 μg/(kg · h).Group F was induced with fentanyl 5 ～ 10 μg/kg and maintained at a rate of 10 ～30 μg/(kg · h).Blood samples were taken before anesthesia (T0),twenty minutes after aortic declamping (T1),the end of operation (T2),6 h (T3),and 24 h (T4) after cardiopulmonary bypass (CPB) for determination of plasma concentration of troponinⅠ and IL-6.Results Compared to T0,cTn Ⅰ and IL-6 in three group at T1,T2,T3 were significantly higher (P ＜ 0.05),cTn Ⅰ reached the peak level at T4 (P ＜ 0.05),IL-6 reached the peak level at T3 (P ＜ 0.05).Compared to group F,cTn Ⅰ and IL-6 in groups S and R at T1,T2,T3,and T4 decreased significantly (P ＜0.05).Conclusion Compared to fentanil,sufentanil and remifentanil had comparative advantages on lessening myocardial injury and inhibiting effect of inflammatory for patients who are undergoing cardiac valve replacement.
ABSTRACT
Objective To investigate the relationships between serum inflammatory mediators and myocardial injury in rats with sepsis.Methods Thirty male Sprague Dawley (SD) rats were randomly divided into normal control group and sepsis (0,24,48,72 h) groups.The rats subjected to sepsis were induced with cecum ligation perforation (CLP).Tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),cardiac troponin Ⅰ (cTnI) and B-type natriuretic peptide precursor (NT-proBNP) in the venous blood were measured at 0 h,24 h,48 h,and 72 h after CLP.The lactic acid (Lac) of the arterial blood,cardiac index (CI),acute physiology and chronic health evaluation (APACHE) Ⅱ score were also determined simultaneously.Results The levels of TNF-α,IL-6,cTnI,NT-proBNP,and Lac in sepsis (24 h,48 h,and 72 h) groups were significantly elevated compared to normal control and sepsis (0 h) group.In addition,the number of sepsis (24 h,48 h,and 72 h) groups progressively increased (P ＜0.05).Conclusions It existed a close relationship between serum inflammatory mediators and myocardial injury,and made myocardium damage after CLP.