Different Dose Aprotinin On The Inflammatory Response In Cardiopulmonary Bypass

Cardiac operation with cardiopulmonary bypass (CPB) induces a complex inflammatory response, including activation of complement, plasma contact systems (kallikrein/kinin), coagulation, fibrinolytic system and activation of leukocytes and platelets. After activated, neutrophils may generate and release proteolytic enzymes, oxygen-derived free radicals as well as metabolites of arachidonic acid, These products may cause endothelial injury, resulting in most injury induced by CPB. CPB can also initiate systemic cytokine release, the elevated systemic concentration of these proinflammatory cytokines (such as TNF-α, IL-1, IL-6, IL-8)may be related to some complication after CPB. Aprotinin has been widely used in clinic to reduce principally blood loss during and after CPB, its hemostatis effect was ascribed to its antifibrinolytic properties and perserving effect on platelet function. Because of its nonspecific antiprotease properties, aprotinin can inhibit trypsin, kallikrein, plasmin and prevent the action of factor Hageman, so it has some antiflammatory properties. This study was further to evaluate the effects of high-dose aprotinin and low-dose aprotinin on the inflammatory response to CPB in clinic and the difference, so that we can provide theory reference for appropriate uses of aprotinin. Methods: adult patients scheduled for valve replacement were randomized into one of the following groups: (1) Control group; (2) Low-dose aprotinin group; (3) High- dose aprotinin group. Double-blind fashion were used in different-dose aprotinin groups.In part 1 of the study, the sample for scanning electron microscopy were taken from arterial filter meshworks, the adhesion and...