Heart Valve Diseases Clinical Trial
Official title:
The Perioperative Effect of Corticosteroid Prophylaxis on the Cardiopulmonary Bypass-Induced Systemic Inflammatory Response
To observe the effect of glucocorticoid on the dynamic changes of monocyte subsets in the peripheral blood of valve disease patients undergoing cardiopulmonary bypass perioperatively.
Systemic inflammatory response syndrome (SIRS) is a common major complication of
cardiopulmonary bypass. "Emergency Hematopoiesis" is the pathological process induced by the
inflammation. The investigators previously confirmed that emergency hematopoiesis induced by
cardiopulmonary bypass led to dynamic changes of quantities of monocyte subsets, there is a
significant increase in the number of two monocyte subsets: 1) CD14highCD16+ monocyte with
strong immunomodulatory activity; 2) CD14lowCD16- monocyte with potential ability of
proliferation and differentiation. Therefore, a new hypothesis risen: "the change of the
function and the number of monocyte subsets induced by emergency hematopoiesis play an
important role for SIRS occurrence after cardiopulmonary bypass, correcting emergency
hematopoiesis is a new breakthrough in the prevention and treatment of SIRS." To identify the
mechanism of function changed in different monocyte subsets during the pathogenesis of SIRS,
the research intended to target perioperative-period patients with heart valve replacement,
monitor dynamically the number and phenotype of peripheral blood monocyte subsets by flow
cytometry; sort out of different monocyte subsets for cell culture in vitro, observe the
ability of proliferation and differentiation and effects between monocyte subsets and T
lymphocyte; investigate the mechanism of immune function changes with antibody-blocking and
compartment culture in patients; observe the impact of glucocorticoid treatment on the
emergency hematopoiesis, offer new objects for evaluation of immune status in patients and
provide new evidence for anti-inflammatory therapy .
Patients should be follow the protocol of cardiopulmonary bypass according to normal hospital
routine practice.
A total of 30 patients will be enrolled in this clinical trial.
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