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首页> 外文期刊>Circulation journal >Cardioprotective effect of aprotinin on myocardial ischemia/reperfusion injury during cardiopulmonary bypass.
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Cardioprotective effect of aprotinin on myocardial ischemia/reperfusion injury during cardiopulmonary bypass.

机译：抑肽酶对体外循环期间心肌缺血/再灌注损伤的保护作用。

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BACKGROUND: Aprotinin is a serine protease inhibitor used extensively in cardiac operations to reduce postoperative bleeding. It also has cardioprotective effects in ischemia/reperfusion injury. In this study, the effects of aprotinin on the release of cardiac markers were evaluated in patients who had good ventricular function and were undergoing coronary artery bypass grafting with cardiopulmonary bypass (CPB). METHODS AND RESULTS: Eighty male patients with an ejection fraction >or=40%, were randomized into either an aprotinin (Group-I; n=40) or control (Group-II; n=40) group. Patients in the aprotinin group received the full Hammersmith doses of aprotinin (2 x 10(6) KIU pre-CPB, 2 x 10(6) KIU at pump prime, 500,000 KIU/h during CPB), whereas the patients in the control group received only saline solutions. Cardiac troponin-I (cTnI) levels were measured before surgery, immediately after surgery, and at postoperative 6(th), 12(th), 24(th) h and 5(th) day. Creatine kinase (CK)-MB measurements were performed at the same time except for the postoperative 5(th) day. Cardiac index (CI), mixed venous oxygen saturation and lactate dehydrogenase (LDH) measurements were also performed. CONCLUSION: Although all patients were in reasonable condition, less myocardial enzyme leakage occurred on the aprotinin group, suggesting that aprotinin has a protective effect on the myocardium beyond that achieved with blood cardioplegia and systemic hypothermia. Because of aprotinin's effects on multiple targets of metabolism, its protective value might increase in more complicated cases.
机译：背景：抑肽酶是一种丝氨酸蛋白酶抑制剂，广泛用于心脏手术以减少术后出血。它还在缺血/再灌注损伤中具有心脏保护作用。在这项研究中，评估了抑肽酶对心室功能良好且接受冠状动脉搭桥术并进行体外循环（CPB）的患者的心脏标志物释放。方法和结果：80例射血分数≥40％的男性患者被随机分为抑肽酶（I组; n = 40）或对照组（II组; n = 40）。抑肽酶组的患者接受了完整的Hammersmith剂量的抑肽酶（CPB前为2 x 10（6）KIU，泵启动时为2 x 10（6）KIU，CPB期间为500,000 KIU / h），而对照组为患者仅接受盐溶液。在手术前，手术后和术后第6、12、24、5和5天分别测量心肌肌钙蛋白I（cTnI）水平。除术后第5天外，同时进行肌酸激酶（CK）-MB测量。还进行了心脏指数（CI），混合静脉血氧饱和度和乳酸脱氢酶（LDH）测量。结论：尽管所有患者都处于适当的状况，但抑肽酶组心肌酶的渗漏较少，这表明抑肽酶对心肌的保护作用超过了血液停搏和全身性体温过低。由于抑肽酶对多种代谢目标的作用，在更复杂的情况下其保护价值可能会增加。

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