Saetang Mantana, Wasinwong Wirat, Oofuvong Maliwan, Tanasansutthiporn Jutarat, Rattanapittayaporn Laortip, Petsakul Sutthasinee, Duangpakdee Pongsanae, Rodneam Puripong, Boonthum Parin, Khunakanan Supphamongkhon, Churuangsuk Chaitong, Sriwimol Wilaiwan, Chantarokon Amphan, Nuanjun Kanjana, Yongsata Dararat
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Nutrients. 2025 Mar 13;17(6):1006. doi: 10.3390/nu17061006.
Oxidative stress and systemic inflammation during cardiac surgery can lead to postoperative complications. Although vitamin C and thiamine (vitamin B1) have individually demonstrated protective effects, their combined effects remain underexplored. This study aimed to evaluate the efficacy of combined vitamin C and B1 therapy versus that of vitamin C alone in reducing inflammatory and cardiac biomarkers and improving postoperative outcomes in patients undergoing cardiac surgery. In this prospective, double-blind, randomized controlled trial, 64 patients scheduled for elective cardiac surgery at a tertiary care center were randomized to receive either 1000 mg vitamin C or a combination of 1000 mg vitamin C and 100 mg vitamin B1 at four perioperative time points. Primary outcomes included changes in inflammatory biomarkers [C-reactive protein, interleukin-6 (IL-6), and white blood cells], and cardiac biomarkers [creatine kinase-MB, Troponin-I, and lactate dehydrogenase]. Secondary outcomes included hemodynamic parameters and left ventricular function. Compared with vitamin C alone, combined vitamin B1 and vitamin C significantly reduced postoperative cardiac biomarker levels. IL-6 levels were significantly lower immediately in the combined group; however, this effect was not sustained at 24 h post-surgery. Up to 24 h after surgery, no significant differences in hemodynamic stability or left ventricular ejection were observed between the groups. Notably, the combined therapy group demonstrated a lower incidence of postoperative arrhythmias and shorter dobutamine duration within 24 postoperatively. Combined vitamin C and B1 therapy significantly reduced markers of myocardial injury and early inflammatory responses (IL-6) in patients undergoing cardiac surgery, suggesting its potential as a protective agent.
心脏手术期间的氧化应激和全身炎症可导致术后并发症。尽管维生素C和硫胺素（维生素B1）已分别显示出保护作用，但其联合作用仍未得到充分研究。本研究旨在评估维生素C和B1联合治疗与单独使用维生素C相比，在降低炎症和心脏生物标志物以及改善心脏手术患者术后结局方面的疗效。在这项前瞻性、双盲、随机对照试验中，一家三级护理中心计划进行择期心脏手术的64例患者被随机分配在围手术期的四个时间点接受1000毫克维生素C或1000毫克维生素C与100毫克维生素B1的组合。主要结局包括炎症生物标志物[C反应蛋白、白细胞介素-6（IL-6）和白细胞]以及心脏生物标志物[肌酸激酶-MB、肌钙蛋白-I和乳酸脱氢酶]的变化。次要结局包括血流动力学参数和左心室功能。与单独使用维生素C相比，维生素B1和维生素C联合使用显著降低了术后心脏生物标志物水平。联合组的IL-6水平立即显著降低；然而，这种效果在术后24小时未持续。术后长达24小时，两组之间在血流动力学稳定性或左心室射血方面未观察到显著差异。值得注意的是，联合治疗组术后心律失常的发生率较低，术后24小时内多巴酚丁胺的使用时间较短。维生素C和B1联合治疗显著降低了心脏手术患者的心肌损伤标志物和早期炎症反应（IL-6），表明其作为一种保护剂的潜力。
