Effects Of Low-dose Aprotinin And Methylpred-nisolone On The Inflammatory Response Induced By Cardiopulmonary Bypass

Objective:To observe the effects of low-dose aprotinin and methylprednisolone on the inflammatory response induced by cardiopulmonary bypass(CPB).MethodsrThirty patients who underwent surgical correction of congenital heart defects were randomly assigned to three groups:contral group(group C),low-dose aprotinin group(group LA),low-dose aprotinin and methylprednisolone(group LA+M).In group LA ,5× 104KIU/kg of aprotinin was added into the prime solution before CPB.In group LA+M, 10mg/kg of methylprednisolone was infused with 5 × 104KIU/kg of aprotinin being added to the pump prime before CPB.Plasma levers of tumor necrosis factor-α (TNF- α ),interleukin-6(IL-6) and neutrophil integrin cluster of differentiation 11b(CD11b) were measured at following points:before CPB(Tl),after aortic declamping(T2),2h after weaning from CPB(T3) and 24h after weaning from CPB(T4).Results:There were no significant differences in neutrophil CD11b expression and plasma lever of TNF- α, IL-6 before CPB(p>0.05).The plasma lever of TNF- α ,IL-6 in group LA and group LA+M were lower thanthe group C at T2,T3,T4(p<0.05),furthermore,in group LA+M was lower than in group LA at T2,T3(p<0.05).The neutrophil CD11b intergrin expression markedly lower in group LA and group LA+M than in group C and between group LA and group LA+M there were no significant difference.Conclusions:Both CPB and operative stimulus induce the increase of cytokine TNF- a ,JL-6 and neutrophil integrin CD11b upregulation. Low-dose aprotinin is effective to reduce CPB induced inflammatory. Methylprednisolone has a anti-inflammatory effects.In short-run clamping or simple surgical procedure, low-dose aprotinin has a similar anti-inflammatory effect to that of low-dose aprotinin and methylpred-nisolone after CPB.