title: Effect of intraoperative glucose fluctuation and postoperative IL-6, TNF-α, CRP levels on the short-term prognosis of patients with intracranial supratentorial neoplasms.
abstract: OBJECTIVE
  To investigate the effect of intraoperative glucose fluctuation and postoperative interlukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) levels on the short-term prognosis of patients with intracranial supratentorial neoplasms.
  
  
  METHODS
  Eighty-six patients undergoing intracranial excision were selected in The Second Hospital of Jilin University. According to the condition of glucose fluctuation, the patients were divided into group A (glucose fluctuation <2.2 mmol/L, n=57) and group B (glucose fluctuation ≥2.2 mmol/L, n=29). Glucose was assessed by drawing 2 mL blood from internal jugular vein in two groups in the following time points, namely fasting blood glucose 1 d before operation (T0), 5 min after anesthesia induction (T1), intraoperative peak glucose (T2), intraoperative lowest glucose (T3), 5 min after closing the skull (T4), immediately after returning to intensive care unit (ICU) (T5) and 2 h after returning to ICU (T6). 1 d before operation and 1, 3 and 6 d after operation, serum IL-6 and TNF-α levels were detected with enzyme-linked immunosorbent assay (ELISA), and CRP level with immunoturbidimetry. Additionally, postoperative adverse reactions were monitored.
  
  
  RESULTS
  There was no statistical significance between two groups regarding the operation time, anesthesia time, amount of intraoperative bleeding and blood transfusion (P>0.05). The glucose levels in both groups at T1~T6 went up conspicuously compared with that at T0 (P<0.01), and those in group B at T2, T4, T5 and T6 were significantly higher than in group A (P<0.01). Serum IL-6, TNF-α and CRP levels in both groups 1, 3 and 6 d after operation increased markedly compared with 1 d before operation (P<0.01), but the increased range in group A was notably lower than in group B (P<0.05 or P<0.01). Postoperative incidences of hypoglycemia, hyperglycemia and myocardial ischemia in group A were significantly lower than in group B (P<0.05), and respiratory support time obviously shorter than in group B (P<0.01).
  
  
  CONCLUSIONS
  The glucose fluctuation of patients undergoing intracranial excision is related to postoperative IL-6, TNF-α and CRP levels and those with small range of glucose fluctuation have better prognosis.
authors.affiliation: Department of Anesthesiology, The Second Hospital of Jilin University, Jilin, China E-mail : liutiecheng17@sohu.com.
authors.forename: Tie-Cheng
authors.initials: TC
authors.lastname: Liu
authors.forename: Qi-Ran
authors.initials: QR
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism*; D001932:Brain Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D002097:C-Reactive Protein / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D015173:Supratentorial Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D001786:Blood Glucose; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein