Influence of valve replacement on beating heart under mild hypothermia on insulin resistance and immune function in patients with impaired fasting glucose
Li Peng
Abstract：Objective To explore the influence of valve replacement on beating heart under mild hypothermia on insulin resistance and immune function in patients with impaired fasting glucose.Methods Totally 67 rheumatic heart disease patients with impaired fasting glucose who underwent valve replacement on beating heart under mild hypothermia from March 2011 to March 2014 were were randomly divided into arrest group (32 cases) and beating group (35 cases).Patients in arrest group underwent valve replacement on arrested heart under moderate hypothermia,while patients in beating group underwent heart valve replacement on beating heart under mild hypothermia.The changes of blood glucose,insulin,insulin resistance index (HOMA-IR),immunoglobulin (Ig) A,IgG,and IgM before operating (T1),30 min after cardiopulmonary bypass (T2),immediately after cardiopulmonary bypass stopped (T3),immediately after operation completed (T4),2 h (T5),24 h (T6) and 3 d (T7) after operation were compared between groups.Results At T2-T6 time points,the levels of blood glucose,insulin,HOMA-IR were significantly higher than those at T1 time point in arrest group [blood glucose:(10.6 ± 1.3),(13.1 ±2.1),(12.1 ±1.6),(10.7 ±1.5),(8.2 ±0.9) mmol/L vs (6.3 ±0.6) mmol/L;insulin:(6.9 ± 0.9),(9.1±1.3),(7.9±1.2),(7.2±1.2),(6.9±1.2) mIU/L vs (4.9±0.8) mIU/L;HOMA-[R:(3.8±1.2),(4.9±1.1),(4.2 ±1.1),(3.2 ±0.8),(2.3 ±0.8) vs (1.4±0.7)] and beating group [blood glucose:(9.2 ±1.0),(11.0±1.6),(10.8 ± 1.3),(8.3 ±1.0),(6.6 ±0.7) mmol/L vs (6.3 ± 0.5) rmmol/L;insulin:(6.1 ± 1.0),(7.8±1.3),(6.5±1.1),(6.1 ±1.2),(5.7±1.2) mIU/L vs (4.9±0.5) mIU/L;HOMA-IR:(2.6±1.0),(3.8±0.8),(3.2±0.8),(2.4 ±0.7),(1.8 ±0.6) vs (1.4 ± 0.7)] (P ＜ 0.05);they were all significantly lower in beating group than those in arrest group (P ＜ 0.05).At T2-T6 time points,the levels of IgG,IgA and IgM values were significantly lower than those at T1 time point in arrest group [IgA:(1.5±0.4),(1.7 ±0.6),(1.9±0.7),(1.9±0.7),(2.0 ±0.8) g/L vs (3.0±0.9) g/L;IgG:(7.3 ±2.0),(7.7 ±2.4),(8.3 ±2.3),(10.4±28),(12.3 ±2.9) g/L vs (16.5 ±3.5) g/L;IgM:(0.7 ±0.3),(0.9±0.4),(1.0±0.4),(1.2±0.3),(1.2±0.5) g/Lvs (1.6± 0.6) g/L] and beating group [IgA:(1.6±0.6),(1.8 ±0.6),(1.9±0.8),(2.0±0.7),(2.3±0.8) g/L vs (2.9±0.8) g/L;IgG:(9.4±2.1),(9.9 ±2.1),(10.7 ±2.1),(12.1 ±2.9),(13.8 ±2.9) g/L vs (16.4 ±3.1) g/L;lgM:(0.7 ±0.3),(0.9 ±0.4),(1.2 ±0.4),(1.4 ±0.4),(1.4±0.6) g/Lvs (1.6 ± 0.6) g/L] (P ＜0.05);in beating group,the IgA at T6,the IgG at T2-T6,the IgM at T5,T6 were significantly higher than those in arrest patients (P ＜ 0.05).Conclusion Heart valve replacement on beating heart under mild hypothermia has mitigative effect on insulin resistance and is helpful for maintainance and recovery of immune function in patients with impaired fasting glucose.
Keywords：Valve replacement surgeryMild hypothermiaHeart beatImpaired fasting glucoseInsulin resistanceImmune function
Publication Date：2016-11-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1607-1611 )