抑肽酶剂量对体外循环炎性反应的作用及影响

目的：观察不同剂量抑肽酶对体外循环（ＣＰＢ）心脏手术炎性反应的作用及差异。方法：３２例拉膜置换病人，随机双盲分为３组：对照组、抑肽酶小剂量组、抑肽酶大剂量组，分别于ＣＰＢ前、ＣＰＢ结束、停机后２h取桡动脉血，测定中性粒细胞ＣＤ１１b表达及细胞因子ＴＮＦ－α、ＩＬ－６血浆清凉,:凶肽酶大剂量组中性粒细胞ＣＤ１１b的表达，细胞因子ＴＮＦ－α血浆水平各时间点无明变化，且ＩＬ－６释放减少，小剂量抑肽酶只在停机后２h部分下调ＣＤ１１b表达及降低ＴＮＦ－α血浆水平，两组相比，小剂量抑肽酶作用明显减弱，结论：抑肽酶的抗赕作用存在量效关系，大剂量抑肽酶的效能好于小剂量抑肽酶。

Effects of aprotinin on the inflammatory response induced by cardiopulmonary bypass

Objective: To observe the effects of high-dose aprotinin and low-dose aprotinin on the inflammatory response induced by cardiopulmonary bypass (CPB). Methods: Thirty-two patients who underwent heart valve replacement were randomized in double-blind fashion into three groups: control group (n=6), low-dose group (n=13) and high-dose group (n=13). Blood samples were taken from radial artery at three times intervals: before CPB, at the end of CPB and 2 hours after termination of CPB. Neutrophil CD11b integrin expression, plasma level of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured. Results: The high-dose group demonstrated no significant change in neutrophil CD11b expression and in plasma level of TNF-α, but a significant decrease in plasma level of IL-6. However, the low-dose group only demonstrated a lower CD11b expression and a lower TNF-α level at 2 h after CPB termination. Conclusion: Aprotinin has a dose-reponse effect. High-dose aprotinin is more effective in the reduction of inflammatory response induced by cardiopulmonary bypass.