Effects of dexamethasone on blood S100β and Neuron Specific Enolaselevels in cardiac valve replacement patients undergoing cardiopulmonarybypass

Abstract

Abstract: AIM: To observe the effects of dexam-ethasone (DXM) on blood S100Β and Neuron SpecifieEnolase NSE) levels of cardiac valve replacement pa-tients undergoing cardioqulnonary bypass (CPB). METHODS: 30 patients, who were 31-63 years old,weighted 46-76 kg, ASAIl-Ill, were randonized toreceived 0.5 mg/kg dexanethasone (dexanethasonegnoup) or plceho(control group) 60 minutes before oper-alion. The plasma levels of TNF-α, IL-Iβ, S-1003 ard NSE were measured at the follwing times: before thedexamethasone or lacehe were aiminisered(T₁) before-stating CPB(T₂), the end of CPB(T₃), imnediately af-ter oeration T₄).24 h aler skin doue(T₅) and 48hafter skin closure(T₆). RESULTS: Both the plasrna com-centrations of TNF-α, IL-Iβ were upregulated after T₂.S-100 β, and NSE were upregulated after T₃(P < 0.05)and alnoestly resume to nomal level at T₆. The plasma cocentratins of TNF-α, IL-Iβ, S100βand NSE in dex-amethasone group were lower than those in placebo grup(P < 0,05). CONCLUSION Dexamethasone may de-crease the blood S-100Β and NSE levels after cardiopul-monary bypass by iting the release of prinfianmnatory cytokine.

Key words: dexamethasone, cardioqulmonary by-pas, systemic inflammalory response syndromns, inflam-matory cytokine, erebral protection

CLC Number:

R969

LUAN Hai-hong, WANG Shi-lei, WANG Shi-duan, JIANG Yan, YUAN Li, LIU Ying-zhi. Effects of dexamethasone on blood S100β and Neuron Specific Enolaselevels in cardiac valve replacement patients undergoing cardiopulmonarybypass[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2007, 12(12): 1424-1427.

References

[1] 余奇劲. 体外循环心脏手术脑损伤生化标记物的监测[J].国外医学麻醉学与复苏分册, 2002;23:87-88.
[2] 金沐,谭洁芳,黄文起,等.浅低温体外循环心内直视手术对病人颅内血浆 S100蛋白和NSE 水平的影响[J].中华麻醉学杂志, 2001;21: 279-282.
[3] Rothoerl RD, Brawarski A, Woertgen C. S-100β protein serum levels after cortical impact injury in the rat[J]. Acta Neurochir (Wien), 2000; 142: 199-203.
[4] Woertgen C, Rothoerl RD, Wiesmanr M, et al. Glial and neu-ron Seum markers after controlledl corical impac! injury in therat[J]. Acta Neurochir Suppl, 2002;81:205-207.
[5] Mussack T, Biberthaler P, Kanz KC,et al. Immediate S2100Band neuron specifc enolase plasma meusurements for rapid eval-uation of primary brain damage in aulcohol intoxicated, minorhead injured patients[J]. Shock, 2002; 18:395-400.
[6] Georgadis D, Berger A, Kowatschev E, et al. Predictive value of S100β and neuron specifc enolase levels for adverse neurolog-ic outcrome after cardiac surgery[J]. J Thorac Cardiovasc Surg,2000;119-138.
[7] Asraf S, Bhattacharyu K,Tian Y, et al. Cytokine and SI00β lev-els in puediatric patients undergoing corrective cardiac surgery with or without total circnlatory arrest[J]. Eur 」Cardiothorac Surg, 1999;16:32-37.
[8] 冀亚琦,阮新民, 孙培吾,等,体外循环中S100蛋白和神经元特异性烯醇化酶的变化以及与炎性因子的关系[J].中国胸心外科心血管杂志,2004;11:248-251.
[9] Le M aire SA, Bhama JK, Schm itling ZC, et al. S100β corte-lates w ith neuro logie comp lications afler aortic operation using cireulato ry arrest[J]. Ann Thorac Surg, 2001; 71: 1913-1919.
[10] ErbMA, Heineman MK, Wendel HP, et al. S2100 aferorection of congenital heart (defects in neonates: is it a reliablemurker for crrbral damage[J]? Ann Thorac Surg, 2000;69:1515-1519.
[11] Tetta C, Fonsalo V, Ronco C, et al. Recent insights into the puogerisi of severe sepsis[J]. Citl Care Resusi 205;7:32-39.
[12] Takizawa S, Ozaki H, Kraki H. Posible invovement of K'channel opening t0 the itreukin-I beta induced inibtion ofvacular smoo musele wnteation[J]. J Vel Med Sci, 19961:357-360.
[13] 周建美,邹定全,常业恬.体外循环心脏手术病人脑组织炎性细胞因子与脑损伤的关系[J].中华麻醉学杂志,2005; 12:935-940.
[14] 张德林,祝胜美,甄威,等,地塞米松对体外循环诱发犬心肺脾及外周血单核细胞TL.R-4mRNA表达的影响[J].中华麻醉学杂志,2006;7:591-594.
[15] 王寿勇,张诗海,姚尚龙.地塞米松对体外循环下心脏瓣膜置换术患者肺弥散功能的保护作用[J].中华麻醉学杂志,2006;26:491-492.
[16] Wadekar SA, LI D. Periyasamy S, et al. Inhibition of heat shock transcription factor by GR[J]. Mol Endocrinol, 2001;15: 1396-1410.
[17] Lu Y,Fukuda K,Liu Y,ct al. Dexamethasone inhibition of IL-Iindluced collagen degradation by coreal fibroblasts in three-di-mensional culure[J]. Invest Ophthalmol Vis Sei, 2004;45:2998-3004.
[18] Shan B. Zhou Y, Chin D, et al. Cyelin-dependent kinase is required for tumor necrosis factor-alpha-stimulated matrix metal-loproleinas-9 expression in human lung adenocarcinom cells[J]. J Biol Chem, 2005;280:1103-1111.