【摘要】 目的　了解全量及小剂量抑肽酶对体外循环 (CPB)炎性反应及心肌损伤的影响。方法　 18例择期CPB心脏手术患者随机分为三组 (每组 6例 ) :对照组 (C组 )、小剂量抑肽酶组 (LA组 )、全量抑肽酶组 (FA组 )。分别于术前 (T1)、CPB6 0min(T2 )、CPB结束后 30min(T3)、4h(T4)及 2 4h(T5 )各时间点测定动脉血中下列各指标的水平 :肿瘤坏死因子 α(TNF α) ,白细胞介素 6 (IL 6 ) ,中性粒细胞整合素 (CD11b) ,细胞粘附分子 (ICAM 1) ,白细胞介素 10 (IL 10 )及肌钙蛋白T(TnT)。结果　TNF α:在CPB后各时间点 ,LA组及FA组均明显低于C组 (P <0 0 5 ) ,在T4及T5FA组明显低于LA组 (P <0 0 5 )。IL 6 :FA组在CPB结束后各时间点均明显低于其它两组 (P <0 0 5 )。CD11b :在T3和T4,LA组及FA组均明显低于C组水平 (P <0 0 5 ) ,而两组之间无明显差异。ICAM 1:在T3和T4LA组及FA组均比C组明显降低 (P <0 0 5 ) ,而两组之间无明显差异。IL 10 :在T3FA组较C组明显升高 (P <0 0 5 )。TnT :LA组在T4和T5明显低于C组 ,而FA组在CPB中及其后各时间点均明显低于C组 ,且在T4和T5明显低于LA组 (P <0 0 5 )。结论　全量抑肽酶能更有效地抑制CPB诱发的炎性反应和心肌损伤更多还原

【Abstract】 Objective To compare the effects of different dose aprotinin on cardiopulmonary bypass induced inflammation and myocardial injury Methods Eighteen adult patients undergoing cardiopulmonary bypass (CPB) were divided into three groups (n=6): control,low dose aprotinin and full dose aprotinin Plasma levels of tumor necrosis factor α(TNFα), interleukin 6(IL 6), interleukin 10(IL 10), intercellular adhesion molecule 1(ICAM 1), troponin T(TnT) and neutrophil integrin cluster of differentiation 11b(CD11b) were measured at following points: before CPB(T1);1 h of CPB (T2) ;30 min after weaning from CPB (T3); 4 h after weaning from CPB (T4) ; and 24 h after weaning from CPB(T5) Results TNFα: the values in two aprotinin using groups were lower than the control levels at T2, T3 and T4 , furthermore, in full dose group was lower than in low dose group at T4 , and lower than two other groups at T5 (P<0 05) IL 6: the values in full dose group were lower than those in two other groups after weaning from CPB (P<0 05) CD11b: the values in two aprotinin using groups were lower than those in control group (P<0 05) ICAM 1: the values in two aprotinin using groups were lower than the control levels at T3 and T4 (P<0 05) IL 10: the values in full dose group were higher than those in control group at T3 (P<0 05) TnT: the values in low dose group were lower than control values at T4 and T5, whereas in full dose group were lower than the values in control group following CPB and in low dose group at T4 and T5 (P<0 05) Conclusions Full dose aprotinin is more effective to reduce cardiopulmonary bypass induced inflammation and myocardial injury than low dose aprotinin更多还原