抑肽酶、潘生丁在体外循环中应用比较的研究

Experimental Study in Comparison ofAprotinin and Dipyridamole during Cardiopulmonary Bypass

在体外循环心脏直视手术的２０只绵羊的动物实验模型中应用丝氨酸蛋白酶抑制剂──抑肽酶，并与潘生丁作比较，通过测定ＴＸＡ２及ＰＧＩ２的变化，血小板超微结构的改变，以及术中术后的观察，证实抑肽酶确能有效地保护血小板功能，减轻血小板的激活释放及损耗，维护正常健全的凝血机制，达到明显减少术中术后出血与渗血之目的。

Twenty sheep were divided into threegroups(C Control,n=6;A Aprotinin,n=7,total dose of1 ,200,000 KIU each;and DDipyridamole,n=7,total dose of 80mg each).All animals underwent cardiopulmonary by-pass.The observation revealed:1.PLT countof A was higher than D and C,however,afterhaving been corrected for hemodilution,nosignificant difference was found.2.At the be-ginning and during CPB,TXB2 and ratio ofTXB2/6- Keto-PGFl a were significantly in- creased in C,also somewhat increased in D,but were suppressed in A, which remained al- most unchanged at the preopetative level.(P<0.01)3.PLT ultrastructure by transmissionelectronic microscope found that there weredeformity in shape,vacuolation of granula,and the tendency of undergoing the process ofphagocytic endocytosis in C,meanwhile,itsmorphology remained normal with abundantgranules in A. D was between A and C. 4. Generally the surgical field of animal lookedvery dry in A at the end of operation,but inthe other two groups profound and extensiveoozing were noticed. The conclusion:Aprotininprovides effective protection for PLT func-tion,preventing it from activation and con-sumption as well as reduction in the countduring CPB. It also has the potential to main-tain the normal hemostatic mechanism,result- ing in the marked reduction of postoperativeoozing and blood loss.