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复杂心血管手术中,术中细胞因子血液吸附可使心肌微小RNA-133a的血浆水平升高。

Plasma Levels of Myocardial MicroRNA-133a Increase by Intraoperative Cytokine Hemoadsorption in the Complex Cardiovascular Operation.

作者信息

Wagner Robert, Soucek Premysl, Ondrasek Jiri, Fila Petr, Sterba Jan, Spacilova Hana, Michalcikova Alzbeta, Freiberger Tomas, Nemec Petr

机构信息

Department of Cardiac Anesthesia, Centre for Cardiovascular and Transplant Surgery (CKTCH), Pekarska 53, Brno, Czech Republic.

These authors contributed equally to this manuscript.

出版信息

J Clin Med Res. 2019 Dec;11(12):789-797. doi: 10.14740/jocmr3989. Epub 2019 Nov 24.

Abstract

BACKGROUND

Complex cardiovascular procedures may initiate a systemic inflammatory response syndrome (SIRS) with a massive cytokine release, which is involved in postoperative myocardial injury. Intraoperative cytokine hemoadsorption (HA) mitigates the inflammatory response. Micro ribonucleic acids (miRNAs) are emerging as a marker of myocardial injury.

METHODS

This study evaluated if intraoperative cytokine reduction by HA modulates SIRS and affects myocardial injury as measured by miRNA-126, 223 and miRNA-1, 133a, respectively. Twenty-eight patients were assigned into HA (n = 15) and control (C) (n = 13) groups. HA was performed by integrating CytoSorb™ into the extracorporeal circuit.

RESULTS

MiRNA-133a plasma levels were increased postoperatively in both groups but were much higher in the HA group than in the C group at 3 h (P = 0.037) and 18 h (P = 0.017) after reperfusion. MiRNA-1 and miRNA-223 plasma levels were significantly increased postoperatively, but did not differ between groups. The vascular miRNA-126 was not affected.

CONCLUSION

Intraoperative cytokine HA in cardiovascular operations increased the plasma levels of miRNA-133a, suggesting higher myocardial injury.

摘要

背景

复杂的心血管手术可能引发全身炎症反应综合征(SIRS),伴有大量细胞因子释放,这与术后心肌损伤有关。术中细胞因子血液吸附(HA)可减轻炎症反应。微小核糖核酸(miRNA)正成为心肌损伤的标志物。

方法

本研究评估了通过HA进行术中细胞因子减少是否能调节SIRS,并分别以miRNA-126、223和miRNA-1、133a衡量对心肌损伤的影响。28例患者被分为HA组(n = 15)和对照组(C组)(n = 13)。通过将CytoSorb™整合到体外循环中来进行HA。

结果

两组术后血浆miRNA-133a水平均升高,但在再灌注后3小时(P = 0.037)和18小时(P = 0.017),HA组的水平远高于C组。血浆miRNA-1和miRNA-223水平术后显著升高,但两组间无差异。血管miRNA-126未受影响。

结论

心血管手术中进行术中细胞因子HA会增加miRNA-133a的血浆水平,提示心肌损伤更严重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a3/6879038/8d95c05fb2d7/jocmr-11-789-g001.jpg

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