Effect Of Liposomal Prostaglandin E₁ On Kidney Function During Cardiopulmonary Bypass

Objective:To explore effect of Liposomal Prostaglandin E₁(Lipo-PGE₁)on kidney function during cardiopulmonary bypass(CPB)in cardiac valve replacement.Methods: 20 patients received cardiac valve replacement undergoing CPB were randomly divided into two groups:group L(n=10)and group C(n=10). Patients in group L were administered 3ng/(kg.min)of Lipo-PGE₁ and some other Lipo-PGE₁ was added into priming solution(5ng/ml)of the extracorporeal circulation machine. Patients in group C were only administered the same volume of normal saline in the same way.Thromboxane B₂(TXB₂),6-keto-Prostaglandin F_1α(6-Keto-PGF_1α),Free Hemoglobin(F-HB)and Cystatin C were measured at pre-CPB(T₁),30 min of CPB(T₂),the end of CPB(T₃),1H after of CPB(T₄)and 24H after CPB(T₅).At the same time,theTXB₂/6-Keto-PGF_1αwas calculated.The creatinine and urea nitrogen of pre-operation in blood,the time of operation,CPB duration and aortic clamping,the lowest nasopharyngeal temperature,the volume of liquid into patients' body in operation and the volume of urine in operation and 24H after operation were observed.Result:(1)There were no significant differences between the two groups inecumenical things.(2) TXB₂,6-Keto-PGF_1α and TXB₂/6-Keto-PGF_1α: TXB₂,6-Keto-PGF_1α were significantly higher than the baseline at T₂-T₄,the highest was at T3. TXB₂ at same time in group L was lower than in group C (P<0.01). 6-Keto-PGF_1α at the same time in group L was higher than in group C (P<0.01) . TXB₂/6-Keto-PGF_1α was higher than the baseline from T₂ to T₃.And TXB₂/6-Keto-PGF₁ was lower in group L than in group C at the same time.(3)F-HB:F-HB was significantly higher than the baseline at T₂-T₅ ,the highest was at _T3.At the same in group L was lower than in group C.(4) Cystatin C: Cystatin C was significantly higher than the baseline at T₂-T₅ ,the highest was at T₃.At the same in group L was lower than in group C.(5)Urine volume in CPB and 24H after CPB:There were no significant difference between the two groups.Conclusionr(1) TXA₂,PGI₂ were hifger during CPB and TXA₂/ PGI₂ was unbalanced in CPB,demonstrating cogulation disorder in CPB.(2)F-HB was higher during CPB and there ws hemolysis in CPB.(3) Cystatin C was higher during CPB and there was glomcrulus injure in CPB.(4) Lipo-PGE₁ can reclaim the unbalance of TXA₂/ PGI₂ in CPB partly to improve coagulation disorder and lessen hemolysis caused by CPB to improve the disorder of blood system during CPB,so can obviously reduce the kidney injure.