钙通道阻滞剂硝苯地平在体外循环期间不能抑制白细胞弹性蛋白酶的释放。

The calcium channel blocker nifedipine fails to inhibit leucocyte elastase release during cardiopulmonary bypass.

作者信息

Massaut J, Hennebert N, Tasiaux N, Demanet H

机构信息

Department of Anesthesiology, Brussels Free University, Brugmann Hospital, Belgium.

出版信息

Acta Anaesthesiol Scand. 1993 Jan;37(1):82-4. doi: 10.1111/j.1399-6576.1993.tb03604.x.

DOI:10.1111/j.1399-6576.1993.tb03604.x

PMID:8424302

Abstract

Circulating concentrations of leucocyte elastase were measured in 16 adult patients undergoing cardiopulmonary bypass (CPB) with a flat-sheet membrane oxygenator. Eight patients (Group I) received the calcium channel blocker nifedipine (9 micrograms.kg-1 x h-1) during CPB. Eight patients (Group II) did not receive any calcium channel blocker during surgery and served as the control group. Elastase concentrations were measured at 7 time points: 2 before, 2 during, and 3 after CPB. The bypass procedure was associated with elevation in elastase concentrations (P < 0.001). Comparing to baseline values elastase concentrations were significantly elevated (P < 0.05) 60 min after the start of CPB and on all measurements done after CPB. Elastase concentrations correlated with the duration of CPB (rs = 0.76, P < 0.001), and were not influenced by nifedipine infusion as revealed by comparing the two groups. This study demonstrates moderate elastase release during CPB with a flat-sheet membrane oxygenator and fails to confirm inhibition of elastase release by nifedipine infusion during CPB.

摘要

对16例使用平板膜式氧合器进行体外循环（CPB）的成年患者测定了循环白细胞弹性蛋白酶浓度。8例患者（I组）在CPB期间接受钙通道阻滞剂硝苯地平（9微克·千克⁻¹·小时⁻¹）。8例患者（II组）在手术期间未接受任何钙通道阻滞剂，作为对照组。在7个时间点测定弹性蛋白酶浓度：CPB前2个时间点、CPB期间2个时间点和CPB后3个时间点。体外循环过程与弹性蛋白酶浓度升高相关（P<0.001）。与基线值相比，CPB开始后60分钟以及CPB后所有测量时弹性蛋白酶浓度均显著升高（P<0.05）。弹性蛋白酶浓度与CPB持续时间相关（rs = 0.76，P<0.001），并且通过两组比较显示不受硝苯地平输注的影响。本研究表明，使用平板膜式氧合器进行CPB期间有中度弹性蛋白酶释放，且未证实CPB期间硝苯地平输注可抑制弹性蛋白酶释放。