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Perioperative Changes of Human β-defensin 2 in Infants with Cardiopulmonary Bypass

Author: ZhangPeiHua
Tutor: ShuQiang
School: Zhejiang University
Course: Pediatrics
Keywords: Cardiopulmonary bypass β- defensin 2 Inflammatory response
CLC: R726.5
Type: Master's thesis
Year: 2010
Downloads: 13
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Abstract

Research background extracorporeal circulation (cardiopulmonary bypass, CPB) downlink heart deformity correction of congenital heart disease (congenital heart disease, CHD) is the most effective treatment. Can trigger the body strong inflammatory response after CPB, the release of a large number of inflammatory cells and cytokines, causing a systemic inflammatory response. Systemic inflammatory response after CPB may cause a variety of complications, such as acute lung injury, cardiac dysfunction and postoperative infection. Therefore, to explore measures to prevent and regulate systemic inflammatory response caused by the CPB, has a crucial importance for reducing the incidence of post-operative complications, improve surgical outcomes, reduce medical costs. Defensins (defensin) is the molecular weight of 4-5KD six cysteine-containing three disulfide bonds cationic antimicrobial peptides, including α-defensins and β-defensins. They are mainly distributed in various epithelial tissues of the body, and myeloid cells. Defensins not only direct killing effect against pathogens, and the role of chemotaxis of immune cells, play a very important role in the acquired immune response in the body. β-defensin-2 was first found in the skin and lung epithelial inducible expression of antimicrobial peptides, the body of a variety of inflammatory cells and cytokines can significantly affect defensin expression levels. Studies have shown that the expression level of postoperative organ function and postoperative infection is closely related to the occurrence and the research group previously proved defensin regulation of the inflammatory response of these critically ill patients and their clinical critically ill patients of these patients follow-up disease occurrence and development of prevention and treatment. As can be seen, the defensin polypeptide as immunomodulatory molecules in regulating the body's inflammatory response, has a very important role in the occurrence and development of organ damage. So far, however, the infant cardiopulmonary bypass β-defensin-2 expression levels is not yet clear. Objective To observe the impact of cardiopulmonary bypass on the baby's body β-defensin-2 expression levels. The period from March 2008 to December of the objects and methods to select hospital 110 patients aged lt; 1-year-old, weight lt; 10Kg, in hypothermic CPB downlink heart open heart surgery, postoperative assisted ventilation with synchronized intermittent mandatory ventilation pressure control mode in children with congenital heart disease. CPB bypass before (T1), the CPB bypass end 0h (T2), postoperative 0h (T3), 12h (T4), 24h (T5), the collection of blood samples of children, at the same time to collect the children lavage solution, and record the children's clinical data. Using a double antibody sandwich enzyme-linked immunosorbent assay (ALISA) detects plasma and lavage fluid beta-defensin-2 and the level of inflammatory cytokines. Analysis baby body defensin expression levels of cardiopulmonary bypass. (1) infant cardiopulmonary bypass surgery perioperative plasma levels of beta-defensin-2 without significant changes (P gt; 0.05). (2) after the end of cardiopulmonary bypass surgery, bronchoalveolar lavage fluid β-defensin-2 levels significantly higher than before the start of CPB (P lt; 0.05), and 12 hours after the end of surgery is still higher than before the start of CPB level. Conclusion infant cardiopulmonary bypass bronchoalveolar lavage fluid beta-defensin-2 levels, but no significant effect of cardiopulmonary bypass on the level of the infant plasma β-defensin 2.

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