西维来司钠对心肺转流犬血小板功能的影响

Influence of sivelestat sodium on the function of platelets during cardiopulmonary bypass in dogs

目的：研究西维来司钠（sivelestat sodium）对犬心肺转流（CPB）中血小板活化／损伤与计数的影响。方法健康成年犬12只随机分为对照组（C 组）和西维来司钠组（S 组）。S 组开始CPB 前静脉注射西维来司钠15 mg／kg，随后静脉维持10 mg·kg^－1·h^－1至 CPB 结束。C 组使用等量生理盐水。建立 CPB 模型，分别于 CPB 前（T1）、阻断升主动脉15 min（T2）、45 min（T3）、开放升主动脉30 min（T4）、60 min（T5）测定血浆弹性蛋白酶（NE）、丙二醛（MDA）、血小板颗粒膜蛋白-140（GMP-140）和血栓素 B2（TXB2）及 Plt 和 Hct。结果与 T1时比较，两组 T2～T5时 NE、GMP-140、TXB2明显升高，T3～T5时 MDA 明显升高，且 S 组明显低于 C 组（P＜0.05）；T2～T5时 Plt 均明显降低，且 S 组明显高于 C 组（P ＜0.05）。结论西维来司钠可降低 CPB 中 NE、MDA、GMP-140、TXB2浓度，抑制血小板活化，减少血小板损伤和消耗，对血小板有较好的保护作用。

Objective To study the influence of sivelestat sodium on platelets activity,injury and count during cardiopulmonary bypass （CPB）in dogs.Methods Twelve adult health dogs were randomly divided into control group （group C,n=6）and sivelestat sodium group （group S,n=6）. Sivelestat sodium at 15 mg/kg was administrated intravenously before the establishment of CPB and then was maintained intravenously at 10 mg·kg^-1·h^-1 to the end of CPB in the group S,and the same volume of saline was used in the group S.The levels of neutrophil elastase （NE）,malondialdehyde （MDA）,granular membrane protein-140 （GMP-140）,thromboxaneB2 （TXB2 ）,the count of plate-lets and the hematocrit （Hct）were measured before CPB,15 and 45 min after cross-clamping and 30, and 60 min after aortic unclamping in both groups.Results The levels of NE,GMP-140,TXB2 at T2-T5 and MDA at T3-T5 were significantly higher than those at T1 in both groups;moreover the lev-els were significantly lower in group S than group C （P〈0.05）.The levels of Plt at T2-T5 were sig-nificantly lower than those at T1 in both groups;moreover the levels were significantly higher in group S than group C （P 〈0.05）.Conclusion Sivelestat sodium reduced the levels of plasma NE, MDA,GMP-140,TXB2 inhibited the activation of Plt,and decreased the injury and consumption of Plt,which presents the protective effects for Plt during CPB.