Randomized Controlled Trial for the Effect of Amrinone and Aprotinin on Proinflammatory Cytokine Release in Patients with Prosthetic Valve Replacement during Perioperative Period
10.3969/j.issn.1672-173X.2001.02.040
- VernacularTitle:氨力农及抑肽酶对瓣膜置换术围手术期炎症细胞因子释放影响的随机对照研究
- Author:
Xijun XIAO
1
;
Chaozhi LUO
;
Xiang ZHUANG
;
Defu YIN
;
Yongxiang CHEN
;
Ge CAO
;
Xuzhong HUANG
;
Zipu TIAN
;
Yingkang SHI
Author Information
1. 华西医科大学附属第一医院
- From:
Journal of Sichuan University (Medical Sciences)
2001;32(2):291-293
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of amrinone and aprotinin on whole-body inflammatory response in the patients with prosthetic valve replacement during perioperative period. Methods 24 patients undergoing prosthetic valve replacment were randomized to control group (group A, n=8) , aprotinin group (group B, n=8) and amrinone combined with aprotinin group (group C, n=8). In the aprotinin group, 3×106 of aprotinin was added to the priming solution of the extracorporeal circulation (ECC). In the amrinone combined with aprotinin group 3×106 of aprotinin was added to the priming solution of the ECC and amrinone began with a bolus of 1mg/kg followed by a maintenance infusion of 8μg/(kg*min). The control group received an equivalent prime volume without aprotinin. Venous blood samples were drawn before the operation, at the end of ECC, 1 hour after the end of ECC, and one day after the operation respectively. Enzyme-linked immunosorbent assay techniques were used to measure each of the cytokines. Results Before ECC, there were no differences of the levels of IL-6 and IL-8 among groups (P>0.05). After ECC, the levels of IL-6 and IL-8 increased significantly in all groups (P<0.05). The levels on day one after the operation were still higher than those before the operation in all groups (except the level of IL-8 in group C), but no statistical significance was observed. (P>0.05). At 1 hour after the end of ECC, the level of IL-6 in group B was lower than that in group A, and the level of IL-6 in group C was lower than that in group B, but there was no statistically significant difference (P>0.05）；At the end of ECC, the level of IL-8 in group B was lower than that in group A and the level of IL-8 in group C was lower than that in group B, but no significant difference was noted (P>0.05). It was also observed that the level of IL-8 was lower in group C than group A or B at 1 hour after the end of ECC. Conclusion Although amrinone and aprotinin have antiinflammatory activity, but pump prime only aprotinin or aprotinin combined with amrinone may fail in preventing proinflammatory cytokine release (IL-6, IL-8) completely in patients with prosthetic valve replacement during ECC perioperative period.
