西维来司钠对体外循环中红细胞的保护作用

The protective effect of Sivelestat sodium hydrate on Erythocytes during cardiopulmonary bypass

目的研究西维来司钠对体外循环(Cardiopulmonary bypass,CPB)期间红细胞的保护作用。方法健康成年杂种犬12条,随机分为对照组(C组)和西维来司钠组(S组)。两组动物均模拟临床开胸,建立体外循环模型,阻断升主动脉45min后开放,开放后继续转机60min。S组于开胸前静脉推注西维来司钠15mg·kg-1,再以10mg·kg-1·h-持续静脉滴注至体外循环结束。C组用生理盐水对照。分别于转机前、阻断15min、45min、开放30min以及开放60min取静脉血测定血浆弹性蛋白酶(Neutrophil elastase,NE))、丙二醛(Malondialdehyde,MDA)含量、游离血红蛋白浓度(FHB)。结果 S组CPB后各时点血浆NE、MDA含量和FHB浓度低于C组。结论 CPB可导致红细胞的损伤,这种机制与CPB期间大量弹性蛋白酶的产生有关,西维来司钠能有效地抑制CPB期间弹性蛋白酶的产生及其活性,对体外循环期间红细胞有保护作用。

Objective To study the effect of Sivelestat, a neutrophil elastase inhibitor on Erythocytes during carcliopulmonary hypass（CPB）. Methods 12 adult hybrid health dogs （10-20kg） were randomly derided into control group （group C n=6） and Sivelestat group （group S n=6）. Two groups were simulated the model of CPB. In group S, Sivelestat（15mg/kg） was administered intravenously before CPB, and then intravenous dripping at 10mg/kg to the end of CPB, Group C was treated with only physiological salt solution. The plasma levels of Neutrophil elastase （NE）, Malondialdehyde （MDA）,FHB were measured befored CPB, 15min and 45min after cross-clamping and 30min and 60rain after aortic unclamping, Results （1） Plasma levels of NE of all dogs after 15min were higher than that before CPB in both groups, hut they were significantly lower in group S than in group C at the same stage（P〈0. 01）. （2） The MDA levels of plasma were increased after CPB in both group （P 〈0. 01）. Group S were lower than group C at 45min CPB and 30min after release cross-clamping （P 〈0.05） ,and at 15min following CPB 60min after release cross-clamping（P〈0. 01）. （3） Plasma levels of FHB of all dogs after 15rain following CPB were higher than that before CPB in both groups （P〈0. 01）, hut significantly lower in group S than in group C （P〈0. 05）. Conclusion Sivelestat may restrain neutrophil elastase from damaging Erythocytes and exert a beficial protective effect during CPB.