Taylor R L, Little W C, Freeman G L, Avery D M, Norris S E, Trinkle J K, Grover F L
Ann Thorac Surg. 1986 Jul;42(1):22-6. doi: 10.1016/s0003-4975(10)61829-2.
Controversy exists as to whether intraaortic (IA) administration of protamine sulfate has less adverse effects than the intravenous (IV) route. The effect of protamine on contractility is not well established. Therefore, 9 dogs underwent chronic instrumentation to monitor aortic pressure (AP), left ventricular (LV) pressure, central venous pressure, cardiac index (CI), heart rate, stroke volume index (SVI), systemic vascular resistance index, and LV volume. The end-systolic LV pressure-volume relationship was used as a load-independent measure of contractility. Each dog was administered IV and IA protamine on separate occasions after pretreatment with heparin. Studies were performed with and without anesthesia. In the awake studies, analysis of variance showed greater decreases in mean AP (p less than .03), CI (p less than .05), and SVI (p less than .02) with IA protamine infusion. In the anesthetized animals, there were no significant differences between IA and IV administration of protamine. Protamine did not decrease contractility in any group. We conclude that IA administration of protamine offers no advantage over IV administration in the dog. Protamine does not decrease contractility when given by either route.
关于硫酸鱼精蛋白主动脉内（IA）给药是否比静脉内（IV）给药不良反应更少，目前存在争议。鱼精蛋白对收缩性的影响尚未完全明确。因此，对9只犬进行慢性仪器植入，以监测主动脉压（AP）、左心室（LV）压、中心静脉压、心脏指数（CI）、心率、每搏量指数（SVI）、全身血管阻力指数和左心室容积。收缩末期左心室压力-容积关系被用作与负荷无关的收缩性测量指标。每只犬在肝素预处理后，分别在不同时间接受静脉内和主动脉内鱼精蛋白给药。研究在有麻醉和无麻醉的情况下进行。在清醒状态的研究中，方差分析显示，主动脉内输注鱼精蛋白时，平均主动脉压（p<0.03）、心脏指数（p<0.05）和每搏量指数（p<0.02）下降幅度更大。在麻醉动物中，主动脉内给药和静脉内给药鱼精蛋白之间没有显著差异。在任何一组中，鱼精蛋白均未降低收缩性。我们得出结论，在犬中，主动脉内给予鱼精蛋白并不比静脉内给药更具优势。无论通过哪种途径给药，鱼精蛋白均不会降低收缩性。
