The effect of low-dose aprotinin on the expression of neutrophil CD_(11b)/CD_(18) in open heart surgery
- VernacularTitle:心脏手术中小剂量抑肽酶对中性粒细胞CD_(11b)/CD_(18)表达的影响
- Author:
Lan ZHANG
;
Yongqiu MAO
;
Hong XIAO
;
At ET
- Publication Type:Journal Article
- Keywords:
Aprotinin;
Cardiopulmonary bypass;
Neutrophils;
Anti-inflammatory agents
- From:
Chinese Journal of Anesthesiology
1994;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the inhibition of low-dose aprotinin on systematic inflammatory response during cardiopulmonary bypass. Methods Twenty-eight ASA Ⅱ-Ⅲ patients(male 13, female 15) undergoing valve replacement were studied. The age ranged from 27 to 55 years and body weight from 37 to 70 kg. CPB time ranged from 66 to 218 mm and aortic cross clamping time from 30 to 140 min . The patients were divided into two groups: control group(n=14) and aprotinin group(n = 14) Premedication included intramuscular phenobarbital sodium 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with intravenous midazolam 0. lmg/kg, fentanyl 20-30?g/kg and vecuronium 0. 1-0. 12mg/kg, and maintained with intermittent bolus injection of fentanyl and vecuronium supplemented with isoflurane inhalation. In aprotinin group aprotinin 1?106KIU was infused after induction of anesthesia until thoracotomy, after thoracotomy aprotinin was infused at a rate of 2.5? 106 KIU/h and aprotinin 2. 5 ?106KIU was added to the prime fluid as suggested by Levy. Blood samples were obtained before anesthesia, before CPB and 1h and 24h after CPB for determination of CD11b and CD18 expression on the surface of neutrophil by immunofluoresence flow cytometry. Results The expression of CD11b or CD18 and CPB time were positively correlated(?= 0.644, 0.538, P0.05). 1 h after CPB CD11b/ CD18 expression increased significantly in the control group and was significantly higher than that in the aprotinin group, but at 24h after CPB only CD11b expression in control group was significantly higher than that in aprotinin group. In aprotinin group there was no significant difference in CD11b/CD18 expression between the four intervals.Conclusions CPB-induced systematic inflammatory response may be positively correlated with CPB time. Low dose aprotinin can inhibit the increase in CD11b/CD18 expression after CPB.
