戊乙奎醚对心肺转流中患者血浆sTM和vWF水平的影响

目的研究戊乙奎醚(长托宁)对心肺转流(CPB)全身性血管内皮细胞(VEC)急性损伤的保护作用。方法30例择期瓣膜置换手术患者随机分为两组,每组15例。观察组术前肌注戊乙奎醚0.02mg/kg和吗啡0.01mg/kg;东莨菪碱组术前肌注东莨菪碱0.3mg和吗啡0.01mg/kg。分别于术前、CPB前、CPB后30min、停CPB、手术结束、术后1d和3d采血测血浆可溶性血栓调节蛋白(sTM)和血管性假血友病因子(vWF)的变化。结果两组血浆sTM和vWF在CPB后30min至术后1d均显著增高(P<0.01),术后3d恢复到术前水平。观察组患者CPB期间至术后3d的所有指标均低于对照组。结论CPB可导致全身性VEC急性损伤,戊乙奎醚可以显著减轻CPB导致的VEC损伤。

Effect of penehyclidine on serum sTM and vWF in patients undergoing cardiopulmonary bypass

Objective To study the protective effect of penehyclidine on vascular endothelial cell(VEC)acute injury in the patients undergoing cardiopulmonary bypass(CPB).Methods Thirty patients scheduled for cardiac valvular replacement under CPB were divided into two groups with 15 cases each.The patients in group P received intramuscular injection of penehyclidine 0.02mg/kg and morphine 0.01mg/kg at 30min before operation,and those in group S scopolamine 0.3mg.Blood samples were withdrawn before skin incision,before CPB,at 30min after CPB,the end of CPB,and the end of operation,on the 1st and 3rd postoperative day for detecting the levels of soluble thrombomodulin(sTM)and von Willebrand factor(vWF).Results The levels of sTM and vWF significantly elevated during CPB and on the 1st postoperative day in the two groups compared with those before operation(P<0.01),which returned to the baselines on the 3rd postoperative day.The levels of sTM and vWF were significantly higher in group S than those in group P(P<0.05 or P<0.01).Conclusion Penehyclidine can attenuate VEC damage induced by CPB.