Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Korea.
Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
Sci Rep. 2018 Jul 5;8(1):10197. doi: 10.1038/s41598-018-28505-8.
High expression of cluster of differentiation (CD)39 and CD73 has cardio-protective effects. We hypothesised that the expression of CD39 and CD73 would differ between propofol- and volatile anaesthetic-based anaesthesia in patients undergoing open heart surgery (OHS). The objective of this prospective randomized trial was to compare the changes in CD39 and CD73 levels in CD4 T cells between propofol- and sevoflurane-based anaesthesia during OHS. The study randomly allocated 156 patients undergoing OHS to a propofol or sevoflurane group. Blood was obtained preoperatively and up to 48 hours after weaning from cardiopulmonary bypass (CPB). The expression levels of CD39 and CD73 in circulating CD4 T cells, serum cytokines and other laboratory parameters were analysed. The primary outcome was the expression of CD39 and CD73 on CD4 T cells. Demographic data and perioperative haemodynamic changes did not show significant differences between the two groups. The expression of CD39 and CD73 in the sevoflurane group was significantly lower than in the propofol group (P < 0.001). Other laboratory findings including cardiac enzymes and cytokine levels, did not show significant intergroup differences. Propofol attenuated the decrease in CD39 and CD73 in circulating CD4 T cells compared to sevoflurane-based anaesthesia during OHS.
高表达的分化群 (CD)39 和 CD73 具有心脏保护作用。我们假设在接受心脏直视手术 (OHS) 的患者中,丙泊酚和挥发性麻醉剂基础麻醉之间的 CD39 和 CD73 表达会有所不同。本前瞻性随机试验的目的是比较丙泊酚和七氟醚麻醉在 OHS 期间 CD4 T 细胞中 CD39 和 CD73 水平的变化。该研究将 156 例行 OHS 的患者随机分配到丙泊酚或七氟醚组。在术前和脱离体外循环 (CPB) 后 48 小时内采集血液。分析循环 CD4 T 细胞中 CD39 和 CD73 的表达水平、血清细胞因子和其他实验室参数。主要结局是 CD4 T 细胞上 CD39 和 CD73 的表达。两组患者的人口统计学数据和围手术期血流动力学变化无显著差异。七氟醚组 CD39 和 CD73 的表达明显低于丙泊酚组 (P<0.001)。其他实验室发现,包括心脏酶和细胞因子水平,两组间无显著差异。与七氟醚麻醉相比,丙泊酚在 OHS 期间可减轻循环 CD4 T 细胞中 CD39 和 CD73 的减少。