中国体外循环杂志2018，Vol.16Issue(1)：33-37,5.DOI:10.13498/j.cnki.chin.j.ecc.2018.01.09
右美托咪定对体外循环下心内直视手术患者外周血单核细胞信号通路的影响
Effect of dexmedetomidine on TLRs/MyD88/ NF - κB signal pathway in patients undergoing cardiac surgery under cardiopulmonary bypass
摘要
Abstract
Objective To evaluate the effect of dexmedetomidine on TLRs/MyD88/NF-κB signaling pathway in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). Methods Ninety patients aged 30-64 years, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association classification Ⅱ or Ⅲ), with the left ventricular ejection fraction ＞50％, scheduled for elective cardiac valve replacement surgery with CPB, were divided into three groups (n = 30 each) using a random number table: dexmedetomidine group one (group D1), dexmedetomidine group two (group D2) and control group (group C). In group D1 and D2, a 0.5 μg/kg (group D1) and 1.0 μg/kg (group D2) bolus dose of dexmedetomidine were administered before the induction of anesthesia, followed by a 0.2 μg/ (kg · h) (group D1) and 0.4 μg/ (kg · h) (group D2) infusion until the end of operation, while in group C equal volume of normal saline was infused instead of dexmedetomidine. Before anesthesia induction (TO), atlh, 3h, 5h, 12h, and 24 h (T1-T5) after termination of CPB, blood samples were collected to detect the expression levels of toll -like receptor 2 and 4 (TLR2, 4), myeloid differentiation factor 88 (MyD88) and nuclear factor KappaB(NF-κB) in peripheral blood CD 14+ mononuclear cells using flow cytometry and to measure the concentrations of tumor necrosis factor-alpha (TNF-α) in plasma by enzyme-linked immunosorbent assay. Results Compared with group C, the expression levels of TLR2, 4, MyD8B and NF-κB in peripheral blood and CD14+ mononuclear cells were significantly decreased, the concentrations of TNF-α were significantly decreased at 1 h, 3 h, 5 h, 12 h, and 24 h (T1-T5) after termination of CPB in group D1 and group D2 (P ＜0.05). Compared with group D1, the expression levels of TLR2, 4, MyD88 and NF-κB in peripheral blood and CD14+ mononuclear cells were significantly decreased, the concentrations of TNF-α were significantly decreased at 1h, 3h, 5h, 12h, and 24 h (T1-T5) after termination of CPB in group D2 (P ＜0.05). Conclusions The mechanism by which dexmedetomidine reduces inflammatory responses is related to inhibition of the activation of TLRs/MyD88/NF-κB signaling pathway in a dose-dependent manner in patients undergoing cardiac surgery under CPB.关键词
右美托咪定/体外循环/Toll样受体/髓样分化因子88/核转录因子κBKey words
Dexmedetomidine/Cardiopulmonary bypass/Toll-like receptor/MyD88/NF-κB引用本文复制引用
罗琳,魏晓,李美霞..右美托咪定对体外循环下心内直视手术患者外周血单核细胞信号通路的影响[J].中国体外循环杂志,2018,16(1):33-37,5.基金项目
海南省自然科学基金(817385) （817385）
