Friedman M, Wang S Y, Sellke F W, Franklin A, Weintraub R M, Johnson R G
Department of Surgery, Beth Israel Hospital, Boston, Massachusetts 02215.
Ann Thorac Surg. 1995 Mar;59(3):598-603. doi: 10.1016/0003-4975(94)00919-8.
Previous studies have shown an increase in left atrial plasma thromboxane (TBX) level and associated increase in lung injury parameters after total cardiopulmonary bypass (t-CPB) but not after partial cardiopulmonary bypass (p-CPB). We used dazmegrel to study the effect of TBX synthesis inhibition on lung injury after t-CPB compared with p-CPB. Sheep were placed on t-CPB without ventilation and with pulmonary artery occlusion (n = 7) or p-CPB with ventilation and an unrestricted pulmonary artery (n = 7). All sheep were treated with dazmegrel. After 90 minutes we separated the sheep from CPB. Plasma TBX, platelets, white blood cells, protein concentration, lung lymph protein, flow, and pulmonary vascular resistance were measured before and after CPB. Lung biopsies were also obtained. Minimal derangement of these pulmonary parameters was seen after either p-CPB or t-CPB. Inhibition of TBX synthesis virtually eliminated the lung injury previously reported after t-CPB, when compared with p-CPB. Clearly TBX has an important role in mediating lung injury after t-CPB.
先前的研究表明，在进行完全体外循环（t-CPB）后，左心房血浆血栓素（TBX）水平会升高，同时肺损伤参数也会相应增加，但部分体外循环（p-CPB）后则不会出现这种情况。我们使用达美格雷来研究与p-CPB相比，抑制TBX合成对t-CPB后肺损伤的影响。将绵羊置于无通气且肺动脉闭塞的t-CPB（n = 7）或有通气且肺动脉无限制的p-CPB（n = 7）下。所有绵羊均接受达美格雷治疗。90分钟后，将绵羊从体外循环中分离出来。在体外循环前后测量血浆TBX、血小板、白细胞、蛋白质浓度、肺淋巴蛋白、流量和肺血管阻力。还获取了肺活检组织。无论是p-CPB还是t-CPB后，这些肺部参数的紊乱都很轻微。与p-CPB相比，抑制TBX合成实际上消除了先前报道的t-CPB后的肺损伤。显然，TBX在介导t-CPB后的肺损伤中起着重要作用。
