抑肽酶抗肺缺血再灌注损伤的临床研究  

CLINICAL RESEARCH ON APROTININ REDUCING LUNG LSCHEMIA REPERFUSION INJURY

作　　者：束余声 朱秉智[2] 秦建伟[2] 

机构地区：[1]扬州大学临床医学院,江苏扬州225001 [2]南京医科大学第一附属医院,江苏南京210009

出　　处：《江苏临床医学杂志》2002年第3期204-206,210,共4页Journal of Jiangsu Clinical Medicine

基　　金：江苏省卫生厅资助课题

摘　　要：目的 :探讨抑肽酶对体外循环 (CPB)肺缺血再灌注损伤保护作用及可能的机制。方法 :2 1例心内直视手术患者随机分为对照组 (n =10 )和实验组 (n =11) ,实验组给予抑肽酶处理。测定 2组不同时段左右心房中白细胞、血浆内皮素 ,呼吸指数 ,并观察肺组织结构。结果 :CPB后对照组左右房血中中性粒细胞计数有显著差异 (P <0 .0 1) ,实验组无差异 (P >0 .0 5 ) ;内皮素及呼吸指数对照组在CPB开始后 2者即有明显升高 ,CPB结束后达高峰 ,至术后 8h仍维持较高水平 ,而实验组CPB期间 2者无明显升高 ,2组比较有显著性差异 (P <0 .0 1) ;电镜观察 :对照组可见肺泡内大量白细胞聚集 ,Ⅰ、Ⅱ型细胞损伤 ,血管内皮细胞肿胀 ,核固缩。而实验组形态学改变较少。结论 :抑肽酶对CPB肺缺血再灌注损伤起到了良好的保护效果。Objective:To study protective effect and its mechanism of aprotinin on reducing lung ishemia/reperfusion injury induced by Cardiopulmonary Bypass.Methods:21 patients undergoing open-heart surgery were divided randomly into the control group (n=10) and the experimental group (n=11).The patients in the experimental group were administered Aprotinin.Blood neutrphile count,endothelin(ET) and respiratory index (RI) were measured and blood samples were taken from the left and right atrium and the radial arterial line.The lung ultrastructure in both groups were examinated.Result:In the control group,the white cells countel in left atrium blood was significatly lower than that in the right atrium after CPB (P<0.01).The ET and RI were significantly lower in the experimental group than in the control group during the CPB(P<0.01).The histological examination of the lung under electron microseop confirmed that the degree of lung was significantly decreased in to experimental group.Conclusions:Aprotnin can obviously reduce lung ischemic/reperfusion injury in cardiopulmonary bypass.

关 键 词：体外循环 肺缺血再灌注损伤 抑肽酶 肺保护 CPB 

分 类 号：R654.1[医药卫生—外科学]