体外循环时心肌细胞上粘附分子的变化及抑肽酶对其表达的影响

目的：观察行心脏瓣膜置换术的病人在体外循环（CPB）前，后心肌细胞间粘附分-1(ICAM-1）及血管细胞间粘附分子－1（VCAM－1）的表达，并探讨抑肽酶对其表面的影响，方法：20例病人被随机均分为抑肽酶组和对照组，分别于手术开始及结束时取右心房心肌标本，采用免疫组化法检测心肌细胞及心肌血管内皮细胞上ICAM－1及VCAM－1的表达（IOD值）。结果：对照组心脏瓣膜我术病人CPB后心肌细胞上和心肌血管内皮细胞（EC）上ICAM－1及VCAM－1的表达较术前有明显增加（P＜0．05），而在抑肽酶组则无明显变化，组间比较，差异有具有显著意义，P＜0．05，结论：CPB时心肌细胞及心肌血管EC上ICAM－1及VCAM－1的表达增高，抑肽酶可通过抑制这些粘附分子的表达而减轻CPB所致的炎症反应。

Changes of adhesion molecule on myocardium during cardiopulmonary bypass: influence of aprotinin

Objective: To study the expression of adhesion molecule on myocardium in patient with heart valve replacement during cardiopulmonary bypass (CPB), and to evaluate whether aprotinin could influence its expression. Methods: In a randomized, prospective study, 20 patients were divided into two groups: aprotinin group (n=10) and control group (n=10). Atrial biopsy specimens were obtained before and after CPB. The expressions of ICAM 1 and VCAM 1 on cardiac myocytes were detected. Results: At the end of CPB, ICAM 1 and VCAM 1 on cardiac myocytes and myocardial vascular endothelial cells were significantly increased in control group compared with prebypass value (P<0 05). However, there were no significant difference between prebypass and postbypass in aprotinin group. Conclusion: Aprotinin might reduce the inflammatory response by inhabiting these adhesion molecule.