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血栓素A2受体拮抗剂GR32191B在犬体外循环期间的血流动力学效应。

The haemodynamic effects of the thromboxane A2 receptor antagonist GR32191B during cardiopulmonary bypass in the dog.

作者信息

Mathie R T, Fleming J S, Barrow S E, Arnold J V, Brannan J J, Becket J M, Ritter J M, Taylor K M

机构信息

Department of Surgery, Royal Postgraduate Medical School, London.

出版信息

Perfusion. 1995 Nov;10(6):403-13. doi: 10.1177/026765919501000604.

DOI:10.1177/026765919501000604
PMID:8747897
Abstract

This study examined whether treatment with the specific thromboxane (TX) A2 receptor antagonist GR32191B would result in an improvement in peripheral haemodynamics during and after cardiopulmonary bypass (CPB) in anaesthetized dogs compared with animals given either saline (control) or aspirin. Following thoracotomy, heparinization and aortic cannulation, and 35 minutes before CPB, dogs received intravenously either GR32191B (15 micrograms/kg/min), saline (50 ml bolus) or aspirin (225 mg bolus) (n = 6 per group). Cardiac output (dye dilution), femoral artery blood flow (electromagnetic flowmeter), gastrocnemius muscle tissue perfusion (133Xe clearance), retinal blood flow (fluorescein angiography), and thromboxane biosynthesis (urinary excretion rates of TXB2 and the metabolite 2,3-dinor-TXB2) were measured before, during and after a standard 90 minute period of CPB at 2.4 l/min/m2 and 28 degrees C. The aspirin-treated group manifested an eightfold reduction in TXB2 excretion compared with controls, indicating a decrease in TXA2 biosynthesis. There were few haemodynamic differences between the groups, though the aspirin-treated group had better maintained muscle tissue perfusion post-CPB and significantly fewer retinal microcirculatory occlusions than GR32191B-treated animals. We conclude that specific TXA2 receptor antagonism provides no significant improvement in peripheral haemodynamics; rather aspirin provides a modest haemodynamic benefit.

摘要

本研究旨在探讨与给予生理盐水(对照组)或阿司匹林的动物相比,使用特异性血栓素(TX)A2受体拮抗剂GR32191B进行治疗是否会改善麻醉犬体外循环(CPB)期间及之后的外周血流动力学。开胸、肝素化和主动脉插管后,在CPB前35分钟,犬静脉注射GR32191B(15微克/千克/分钟)、生理盐水(50毫升推注)或阿司匹林(225毫克推注)(每组n = 6)。在CPB标准90分钟期间(流量2.4升/分钟/平方米,温度28摄氏度)之前、期间和之后,测量心输出量(染料稀释法)、股动脉血流量(电磁流量计)、腓肠肌组织灌注(133Xe清除率)、视网膜血流量(荧光素血管造影)以及血栓素生物合成(TXB2及其代谢产物2,3-二去甲-TXB2的尿排泄率)。与对照组相比,阿司匹林治疗组的TXB2排泄减少了八倍,表明TXA2生物合成减少。尽管阿司匹林治疗组在CPB后肌肉组织灌注维持得更好,且视网膜微循环阻塞明显少于GR32191B治疗的动物,但各组之间血流动力学差异不大。我们得出结论,特异性TXA2受体拮抗作用对外周血流动力学没有显著改善;相反,阿司匹林具有适度的血流动力学益处。

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