抑肽酶在体外循环中的抗炎作用

Effect of aprotinin on cardiopulmonary bypass-induced inflammation

目的探讨体外循环过程中全身炎症反应及抑肽酶的抗炎作用。方法选取27例瓣膜置换术患者，年龄35—71岁之间，心功能Ⅱ-Ⅲ级，将他们随机分成2组，其中实验组于体外循环前及体外循环过程中各应用抑肽酶100万kIU。分别于体外循环前、主动脉阻断后10min、停体外循环时、术后24h抽取动脉血测定TNF-α、IL-6、sICAM-1在血浆中的含量。通过统计学分析判断体外循环过程中全身炎症反应及抑肽酶的抗炎作用。结果2组患者的年龄、体重、手术时间、体外循环时间，主动脉阻断时间进行组间比较，差异无显著性(P>0．05)。试验组病人TNF-α、IL-6、sICAM-1在体外循环前与对照组无显著性差异(P>0．05)，而主动脉阻断后10min、停体外循环后、术后24h两组间存在着显著差异(P<0．05)。结论体外循环可引起全身炎症反应，与术后心功能不全相关。抑肽酶是一种丝氨酸蛋白酶抑制荆可以在炎症的不同反应阶段对炎症起抗炎作用。

AIM To evaluate the inhibitory effects of aprotinin on plasma TNF-α, IL-6, slCAM-1 during cardiopulmonary bypass in heart valve replacement patients. METHODS In a randomized, prospective study, 27 patients with heart valve replacement were divided into 2 groups： aprotinin group （n = 16） and control group（ n = 11 ）. Blood sample was collected in three times： before cardiopulmonary bypass（CPB）, 10 rain after aorta blocking, after CPB,24 h after operation to measure content of TNF-α, IL-6, sICAM-1 in plasma. RESULTS It was no significant difference on age, weight,operation time, CPB time, aorta blocking time, between aprotinin and control group. TNF-α, IL-6, sICAM-1 was high in control group than in aprotinin group. CONCLUSION CPB can induce a system inflammation. It is relative to heart failure. Aprotinin may reduce the inflammationreaction reaction.