抑肽酶在心肺转流术中对肺损伤的保护

Aprotinin Reducing Lung Injury During Cardiopulmonary Bypass.

目的 探讨心肺转流术 (cardiopulmonary bypass,CPB)导致肺缺血 -再灌注损伤 ,抑肽酶对肺损伤保护的作用。 方法 将 2 4例心内直视手术的患者随机分为对照组和实验组 ,每组 12例。实验组给予抑肽酶处理。检测CPB前后左、右心房血中中性粒细胞和血小板计数 ,围手术期各时段桡动脉血浆中内皮素、血栓素 B2 、6 -酮 -前列腺素F1α和呼吸指数的变化。 结果 对照组 CPB后左、右心房血中血小板和中性粒细胞计数差异有显著性 (P<0 .0 5 ) ;实验组 CPB前后则差异无显著性 ;内皮素、血栓素 B2 、呼吸指数在 CPB中、CPB后两组比较均差异有显著性 (P<0 .0 1)。 结论 CPB致肺损伤 ,血小板和中性粒细胞在肺内聚集 ,内皮素、血栓素 B2 、6 -酮 -前列腺素 F1α在其病理过程中起重要作用。

Objective\ To study the effect of Aprotinin on lung ischemia reperfusion injury during cardiopulmonary bypass(CPB). Methods\ Twenty four patients 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 and after CPB to determine platelet and neutrophil count. Meanwhile, endothelin(ET), thromboxane B 2 (TXB 2) and 6 Keto prostaglandin F 1α (6 Keto PGF 1α ),respiratory idex(RI) were measured. Results\ In the control group, the platelet and neutrophil count in left atrium blood were significantly lower than that in the right atrium after CPB( P<0.05) . The ET, TXB 2, TXB 2/6 Keto PGF 1α ,RI were significantly lower in the experimental group than those in control group during the CPB ( P<0.01) . Conclusion\ These results demonstrate that platelet and neutrophil aggregation in the lung, ET, TXB 2, and 6 Keto PGF 1α play an important role in lung injury induced by CPB. Aprotinin can obviously reduce lung injury induced by cardiopulmonary bypass.