【摘要】 目的探讨西维来司钠对体外循环(CPB)期间血浆弹性蛋白酶(NE)、补体C3、C4及尿NAG的影响及对肾脏的保护效果。方法将健康成年犬随机分为对照组(C组,N=6)和西维来司钠组(S组,N=6),建立犬CPB模型,两组均在转机前(T1),阻断升主动脉15MIN(T2)、45MIN(T3),开放30MIN(T4)、60MIN(T5)取静脉血和尿液。静脉血离心后测血浆NE和补体C3、C4浓度。尿液测尿NAG。结果①CPB后,两组动物各时点血浆NE含量显著高于CPB前(P<0.01)。同时点组间比较,S组CPB后各时点血浆NE含量均低于C组(P<0.01、P<0.05)。②CPB后C组血浆补体C3含量逐渐下降,CPB末达谷值,明显低于CPB前(P<0.01);组间比较,C组CPB后同时点血浆补体C3含量均低于S组(P<0.01),两组动物血浆补体C4含量无明显差异。③CPB后两组动物尿NAG活性逐渐增加,CPB末达高峰,明显高于CPB前(P<0.01);同时段组间比较,S组尿NAG活性低于C组(P<0.01)。结论CPB中应用西维来司钠可通过抑制NE的活性,减少补体激活及尿NAG活性的增加,对CPB中的肾脏有一定的保护。更多还原

【Abstract】 Objective To study the effect of sivelestat on plasma neutrophil elastase （NE） and C₃,C₄ and urine N-acetyl-beta-D-glucosaminidase （NAG） during cardiopulmonary bypass and its protective effect on renal function. Methods A total of 12 adult hybrid healthy dogs were randomly divided into control group and sivelestat group. The dog model of CPB was established. Levels of plasma NE and C₃,C₄, and urine NAG were detected before CPB （T 1 ）, 15 min （T 2 ） and 45 min （T 3 ） after cross-clamping of aorta, and 30 min （T 4 ）, 60 min （T 5 ） after aortic unclamping. Results Plasma levels of NE were elevated after CPB in both control group and sivelestat group （P<0.01）, but those in sivelestat group were lower significantly than control group after CPB （P<0.01 , P<0.05 ）. In control group, the content of C 3 after CPB was lower than that before CPB （P<0.01）, and reached the lowest point at the end of CPB. The content of C 3 in control group was lower than sivelestat group at the same time points （P<0.01）. The content of C 4 showed no obvious diffe-rence in both groups （P>0.05）. The level of urine NAG obviously increased in two groups （P<0.01） , peaked at the end of CPB. Conclusion Sivelestat inhibits the activation of plasma NE and complement C 3 and production of urine NAG. Hence, it may exert a protective effect on renal function during cardiopulmonary bypass.更多还原