Journal of Life Science (생명과학회지)

Korean Society of Life Science (한국생명과학회)
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Analysis of the Correlations between the Serum Levels of Cytokines and Postoperative Outcomes in Valvular Heart Surgery with Cardiopulmonary Bypass

체외순환을 동반한 심장판막 수술 시 혈청 사이토카인 농도와 수술 후 결과와의 상관관계 분석

  • Moon, Seong-Min (Department of Biomedical Laboratory of Science, College of Smart Foods and Drugs, Inje University) ;
  • Ki, Chong-Rak (Department of Biomedical Laboratory of Science, College of Smart Foods and Drugs, Inje University) ;
  • Kim, Yun-Tae (Seoul Medical Science Institute (SMSI)) ;
  • Choi, Seok-Cheol (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan)
  • 문성민 (인제대학교 식의학생명공학대학 임상병리학과) ;
  • 김정락 (인제대학교 식의학생명공학대학 임상병리학과) ;
  • 김윤태 (서울의과학 연구소) ;
  • 최석철 (부산가톨릭대학교 보건과학대학 임상병리학과)
  • Published : 2008.11.30
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Abstract

Cytokines play a pivotal role in systemic inflammatory response following cardiac surgery with cardiopulmonary bypass (CPB). The purpose of this study was to investigate the perioperative changes in proinflammatory [tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and interleukin-6 (IL-6)] and antiinflammatory cytokines [interleukin-10 (IL-10)], and each correlation between the cytokines and other variables in valvular heart surgery with CPB. Serum IL-6 and IL-10 levels and leukocyte counts significantly increased following CPB. CPB caused hepatic, renal and myocardial dysfunctions. IL-6 levels had positive correlations with IL-10 levels at postoperative periods. TNF-$\alpha$ levels had correlations with leukocyte counts and myocardial marker levels at postoperative 24 hr (PO-24 h). Furthermore, IL-6 or IL-10 levels had positive correlations with other variable such as hepatic, renal or myocardial marker at postoperative periods. These results showed that balance between proinflammatory and antiinflammatory cytokines is maintained during cardiac surgery with CPB, and that these cytokines exert postoperatively inflammatory and antiinflammatory reactions.

본 연구자들은 체외순환을 적용한 심장판막 수술 시 혈청사이토카인들의 변화와 여러 장기 표지자들과의 상관관계규명을 위해 전향적 연구를 실시하였다. 체외순환은 수술 동안 또는 수술 후 시기에 걸쳐 염증성 사이토카인(TNF-$\alpha$ 및 IL-6) 및 항염증성 사이토카인(IL-10)의 혈청 농도의 증가를 가져왔고 염증성 사이토카인의 증가에 따라 항염증성 사이토카인의 길항적 상승이 뒤 따랐다. 또한 심장수술 후 간, 신장, 심장 등 장기의 기능표지자들 역시 기준치보다 증가되었고 사이토카인들은 이러한 장기기능 표지자와 다양한 시기에 걸쳐 유의한 상관성을 보였다. 본 연구의 결과들은 심장판막수술 시 필연적으로 적용하는 체외순환이 염증성 사이토카인을 활성화시키기도 하지만 이의 상쇄를 위한 항염증성 사이토카인의 방출 역시 자극하며 이러한 사이토카인들은 수술 후 여러 장기의 기능에 직간접적으로 관여하여 장기 손상 혹은 장기보호의 역할을 함이 시사되었다.

Keywords

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