ABSTRACT
The study was designed to evaluate the in vitro effects of aprotinin on platelets functions and arachidonic acid metabolism, Venous blood was drawn from healthy volunteers, and aprotinin was added to the blood at three different dose of aprotinin:50KIU/ml,150KIU/ml(low-dose)and 300KIU/ml (high-dose), respectively. Results demonstrated that aprotinin inhibited significantly the rates of platelet adhesion and aggregation induced by ADP or thrombin. Both the inhibitions were reversible and there was not significantly difference between high-dose and low-dose. The ADP-induced activities ofphospholipase A_2 (PLA_2) and cyclo-oxygenase(CLO)of platelet membrane were significantly suppressed by prophylactic aprotinin,but were not by therapeutic aprotinin. It is suggested that administration of low-dose aprotinin during CPB is reasonable,especially gaved just before the start of CPB.
ABSTRACT
To assess the effects of low dose aprotinin on platelets during cardiopulmonary bypass(CPB), 45 Patients, aged 20 to 45 years, ASA grade Ⅱ to Ⅲ,undcrgoing elective operation of cardiac valve replacement under fentanyl-enflurane-atracurium anesthesia, were randomly allocated to receiving aprotinin 2 ?106 KIU (group I,n=23 ) or equivalent volume of normal saline as control (group Ⅱ,n= 22) res12ectively,at the same time as CPB began to work. The blood samples were collected after induction of anes- thesia. 5 mins prior to CPB. 5, 15, 30 and 60 mins following CPB,and immedialely before withdrawal of CPB.to measure such 1parameters of platelet as level of cytoplasmic free Ca2+ (CFCa2+),activities of phosphollpase A2 (PLA2) and cyclouoxygenase (PCO) in membrane,aggregation rate (AGR),adhesion rate (ADR ) and count Individually. The lotal blood volume of postoperative tho- racic drainage solution (TBV ) and the re(]uircd blood volume of transfusioll (RBVT) were recorded. The results ahoys(l that dur lug CP14,the levels of CFCa2+ and activitics of PLA2 and PCO increased significantly,and the AGR,ADR and count of plstclet decreased markedly in both groups (P