抑肽酶、乌司他丁加氨甲苯酸与氨甲苯酸对血液纤溶系统的保护作用

The protection of aprotinin, ulinastatin and aminomethylbenzoic acid, aminomethylbenzoic acid on blood fibrinolytic system during cardiopnlrnonary bypass

目的观察抑肽酶、乌司他丁加氨甲苯酸与氨甲苯酸对体外循环（CPB）心脏手术的血液纤溶系统的保护作用。方法选择36例行风湿性心脏病瓣膜置换术的患者，随机分成三组。抑肽酶组（A组，12例）：在预充液中一次性加入抑肽酶200万U；乌司他丁加氨甲苯酸组（UP组，12例）：在预充液中加入乌司他丁12000U／kg、氨甲苯酸10mg／kg；氨甲苯酸组（P组，12例）：在预充液中加入氨甲苯酸10mg／kg。结果三组CPB时间、输血量比较差异无统计学意义；术后24h胸腔引流量UP组（443．3±150．8）ml、P组（430．0±178．3）ml，与A组的（290．0±98．0）ml比较差异有统计学意义（P〈0．05）。A组有1例发生严重过敏反应。结论抑肽酶、乌司他丁加氨甲苯酸和氨甲苯酸均有维持血液纤溶系统稳定、保护血小板功能的作用，从而减少术中及术后出血。

Objective To observe the protection of aprotinin, ulinastatin and aminomethylbenzoic acid, aminomethylbenzoic acid on blood fibrinolytic system during eardiopulmonary bypass（ CPB ）. Methods Thirty-six patients with rheumatic heart disease who were treated by valve replacement were randomly divided into three groups： aprotinin group （group A, 12 cases）： aprotinin 2000 kU was added into the priming solution; ulinastatin and aminomethylbenzoic acid group （group UP, 12 cases）： ulinastatin 12 000 U/kg and aminomethylbenzoie acid 10 mg/kg was added into the priming solution; aminomethylbenzoic acid group （group P, 12 cases）： aminomethylbenzoic acid 10 mg/kg was added into the priming solution. Results There was no significant difference in CPB time and blood transfusion among three groups; the postoperative 24 h chest tube drainage in group UP was （443.3 ± 150.8） ml, in group P was （430.0 ±178.3） ml and in group A was （290.0 ±98.0） ml, there were. significant differences between group UP, group P and group A （P 〈 0.05 ）. There was 1 case of severe allergic reaction in group A. Conclusion Aprotinin, ulinastatin and aminomethylbenzoie acid, aminomethylbenzoie acid are effective in stabilizing blood fibrinolytie system and preserving platelet function during CPB, leading to less postoperative blood loss.