乌司他丁和抑肽酶对非体外循环下冠脉搭桥术血液保护作用的研究

The protective effects of ulinastatin and aprotinin on the blood under off-pump coronary artery bypass

目的:评估乌司他丁和抑肽酶对非体外循环下冠脉搭桥术(OPCAB)中的血液保护作用。方法:78例行OPCAB患者分为3组,抑肽酶组(24例)术中给予抑肽酶500万U(生理盐水稀释至50mL静脉泵入);乌司他丁组(28例)术中给予乌司他丁2万U/kg(生理盐水稀释至50mL静脉泵入);对照组(26例)术中静脉泵入等量生理盐水。记录围手术期出血量、输血情况及血液细胞相关临床指标。结果:与对照组相比,乌司他丁组与抑肽酶组术后血小板和红细胞计数明显增加(P<0.05),胸液引流量减少(P<0.05)。抑肽酶与乌司他丁的血液细胞保护作用相比较无统计学差异(P>0.05)。结论:抑肽酶和乌司他丁通过多种途径对血液细胞成分有保护作用,维护患者凝血机制,能够明显减少OPCAB围手术期出血及输血量。

To investigate the protective effects of ulinastatin and aprotinin on the blood under offpump coronary artery bypass （OPCAB）. Methods Seventy-eight patients undergoing elective OPCAB were assigned to receive intravenous aprotinin of 5 × 10^6 U （n = 24）, ulinastatin of 2 × 10^4 U/kg （n = 28）, or saline solution （n = 26） during the procudure. Perioperative blood loss, blood transfusion, and various hematocyte counts were documented. Results The counts of erythrocyte and platelet were markedly elevated in aprotinin group or ulinastatin group as compared with those in the control group （P 〈 0.05）. Postoperative blood loss was significantly reduced in either treatment group （P 〈 0.05）. There was no statistical difference between aprotinin and ulinastatin in the protective effect on the cells of the blood （P 〉 0.05）. Conclusion Both ulinastatin and aprotinin can significantly protect the cells of the blood, improve coagulation function, and decline perioperative blood loss and blood transfusion.