抑肽酶对体外循环肺损伤保护机制的临床研究

CLINICAL RESEARCH ON APROTININ REDUCING LUNG INJURYDURING CARDIOPULMONARY BYPASS

目的 :探讨体外循环 (CPB)导致肺缺血—再灌注损伤以及抑肽酶对肺损伤保护作用及可能的机制。方法 :2 4例心内直视手术患者 ,随机分为对照组和实验组各 12例。实验组给予抑肽酶处理。检测CPB前后左右房血中血小板及中性粒细胞数量、围手术期各时段桡动脉血浆中内皮素、血栓素、前列环素及呼吸指数的变化。结果 :对照组CPB后左右房血液中 ,血小板及中性粒细胞计数有显著差异 (P <0 0 5 ) ;实验组CPB前后计数无显著性差异 (P >0 0 5 ) ;内皮素、血栓素、呼吸指数在CPB中、CPB后实验组较对照组显著降低 (P <0 0 5 )。结论 :CPB致肺损伤 ,血小板及中性粒细胞在肺内聚集 ,内皮素、血栓素等在其病理过程中起关键性作用。

Objective:To study the effect of Aprotinin on lung injury during cardiopulmonary bypass (CPB).Methods:24 cases were randomly divided into two groups: control group (n=12) and experimental group (n=12).Blood samples were taken from the left and right atrium before CPB and after CPB to deterimine platelet and white cell count. Meanwhile , eodothelin(ET),thromboxane B 2(TXB 2) and 6Keto- prostaglandin F 1α (6-Keto-PGF 1α ),lung function were measured.Results: It showed that the platelet and white cells aggregae in the control group,the ET,TXB 2, TXB 2/6-Keto-PGF 1α ,RI were significantly lower in the experimental group than in control group during the post-CPB. Conclusion: This study demonstrated that Aprotinin can obviously reduce lung injury after cardipulmonary bypass.