| Objective: To observe and compare the influence of epsilon-aminocaproicacid with aprotinin on protection of platelet and inflammation incardiopulmonary bypass. To evaluate the value of epsilon-aminocaproic acid incardiopulmonary bypass. Methods: Thirty children with acyanotic congenital heart disease wereenrolled in the study. The patients were randomized into two groups: aprotiningroup(A group) and epsilon-aminocaproic acid group(E group).Give differentmedicine to these two groups. Blood samples were taken at the following timepoints respectively, after the induction of anesthesion(prior to skin incisions),30minutes after CPB onset and in the end of the CPB. Measured parametersinclude recorded amount of postoperative bleeding,transfusion amount at 12hours and from 12 to 24 hours. Platelet membrane glycoproteins(GP)Ib,GPIIb,GPIIIa and platelet granule membrane protein(GMP-140) were measuredat the three time points perioperatively. Plasma interleukin-6(IL-6) andinterleukin-10(IL-10) were measured respectively. Results: In the epsilon-aminocaproic acid group, at the CPB over, theplatelet membrane GPIb, GPIIb and GPIIIa were 82.31%±13.45%, 85.71%±8.40% and 86.31%±9.37%, before CPB onset the platelet membrane GPIb,GPIIb and GPIIIa were 96.15%±3.94%,96.88%±3.32% and 97.25%±2.90%,the platelet membrane GPIb,GPIIb and GPIIIa significantly decreased at themoment of the CPB over compared with that of before CPB onset(P﹤0.05). Inthe aprotinin group, at the CPB over ,the platelet membrane GPIb, GPIIb andGPIIIa were 83.15%±13.98%, 86.12%±8.68% and 87.32%±8.97%, beforeCPB onset the platelet membrane GPIb, GPIIb and GPIIIa were 98.37%±3.78%, 95.26%±3.54% and 98.14%±3.64%, they all significantly decreasedat the moment of the CPB over compared with that of before CPB (P﹤0.05). Atthe same time points, before CPB, 30 minutes after CPB onset and CPB over,the platelet membrane GPIb, GPIIb and GPIIIa were not different between theepsilon-aminocaproic acid group and the aprotinin group(P﹥0.05). In the epsilon-aminocaproic acid group, 30 minutes after CPB onset andCPB over, the platelet membrane GMP-140 were 72.24%±8.34% and 78.64%±7.34% respectivly, before CPB onset the platelet membrane GMP-140 was46.32%±2.17%, GMP-140 significantly increased at the moments of 30minutes after CPB onset and the CPB over compared with that of before CPB(P﹤0.05). In the aprotinin group,GMP-140 at CPB over was 78.18%±7.82%,before the CPB onset it was 46.47% ± 3.78%, the platelet GMP-140significantly increased at the CPB over(P﹤0.05). At the same time points theplatelet GMP-140 was not different between the two groups(P﹥0.05). In the epsilon-aminocaproic acid group, the amount of postoperativebleeding was 181±53ml at the 12 hours and 91±28ml from the 12 to 24 housr,and the transfusion amount was 276±162ml. In the aprotinin group, theamountof postoperative bleeding was 196±57ml at the 12 hours and 78±27ml fromthe 12 to 24 hours, and the transfusion amount was 280±158ml. There was nodiffierence between the two groups(P﹥0.05). In the two groups, before the CPB onset , plasma IL-6 and IL-10 respectivlywere 78±11pg/ml, 5.20±0.34pg/ml and 80±13pg/ml, 5.37±0.28pg/ml, therewas no diffierence between them(P﹥0.05). In the epsilon-aminocaproic acidgroup, plasma IL-6 of 30 minutes after CPB onset and CPB over wererespectivly 125 ± 16pg/ml, 232 ± 25pg/ml, they significantly increasedcompared with that of before CPB (P﹤0.05). But in the aprotinin group, the 30minutes after CPB onset and the CPB over, plasma IL-6 were respectivly 92±14pg/ml, 153±18pg/ml, they significantly increased compared with that ofbefore CPB (P﹤0.05). At the same time points of 30 minutes after CPB andCPB over, there was significant difference between the two groups(P﹤0.05). Plasma IL-10 were respectivly 19.03±10.52pg/ml, 89.71±8.48pg/ml atthe moment of 30 minutes after CPB onset and CPB over in the aprotiningroup,they significantly increased compared with that of before CPB (P﹤0.05).IL-10 in the epsilon-aminocaproic acid group at the CPB over was 46.15?...
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