The serum levels of IL-8, IL-10, and TNF-a, cardiac troponin I, creatine kinase-MB in patients with rheumatic heart disease received dexmedetomidine.

BACKGROUND

This study aimed to evaluate the effects of dexmedetomidine (DEX) in patients undergoing valve replacement surgery for rheumatic heart disease (RHD), focusing on its impact on serum levels of inflammatory markers (IL-8, IL-10, TNF-a) and myocardial injury markers (Cardiac Troponin I [cTnI], Creatine Kinase-MB [CK-MB]).

METHODS

A total of 140 patients undergoing cardiopulmonary bypass (CPB) valve replacement surgery at West China Hospital, Sichuan University, between January 2022 and December 2024 were randomly assigned to two groups: the observation group (DEX) and the control group (normal saline). Key perioperative parameters were analysed, including anaesthetic dosage, myocardial injury markers, immune function (CD4+, CD8+, and CD4+/CD8+ ratio), inflammatory factors, and adverse reactions.

RESULTS

The observation group required significantly lower anaesthetic dosages than the control group. Additionally, the observation group exhibited higher heart rate (HR) at T5 and higher mean arterial pressure (MAP) at T2, T3, and T5 (P< 0.05). Myocardial injury markers (cTnI and CK-MB) were significantly lower in the observation group (P< 0.05). While preoperative cellular immune function (CD4+, CD8+, and CD4+/CD8+) was similar between both groups, postoperative measurements showed significantly higher CD4+ and CD4+/CD8+ ratios, and lower CD8+ in the observation group (P < 0.05). Regarding inflammatory markers, IL-8 and TNF-a levels were significantly lower, while IL-10 was higher in the observation group postoperatively (P < 0 .0 5). There were no significant differences in adverse reactions between the two groups (P > 0 .0 5).

CONCLUSIONS

Dexmedetomidine (DEX) reduces anaesthetic usage, supports hemodynamic stability, mitigates myocardial injury, and lowers postoperative inflammatory responses in patients undergoing RHD valve replacement surgery.