The relations of lung injury after cardiopulmonary bypass and infl ammatory reaction, especially neutrophil elastase
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概要
- 論文の詳細を見る
We have proved that Sivelestat preserved lung function after cardiopulmonary bypass（ CPB） in the rabbitmodel. We now report the therapeutic efficacy of Sivelestat in the clinical case. From July 2005, 16 patients whounderwent aortic arch replacements were enrolled in this study. Diagnosis included dissected aortic aneurysm in 6patients, true aortic arch aneurysm in 8, and traumatic aortic arch aneurysm in 1 patient. We randomly divided thesepatients into two groups. In the Pre-Group（ Pre:n=8）, infusion of Sivelestat（ 0.2mg/kg/hr） was started before theoperation; in the Post-Group（ Post:n=8）, it was started after the operation. Serum elastase activity, interleukin-8（ IL-8）levels were measured before the operation, before cessation of CPB and at the end of operation. Blood gas analyses weremeasured before the operation, at one and three hours after the CPB and the next morning. Because the preoperativeP/F ratio（ arterial PO2/FiO2） varies with each case, the value of the P/F ratio at one hour after the CPB was calculatedfor 100%. Elastase activity of both groups were increased at the end of CPB（ Pre:8.9±10.6, Post:4.6± 3.5）, then returnedto baseline level at end of operation（ NS）. IL-8 of both groups were increased at end of CPB, then in the Pre-Groupdecreased to 59.3± 25.0 pg/ml, but in the Post-Group increased to 97.9±45.7 pg/ml（ p=0.09）. The P/F ratio in the Pre-Group was well maintained from post CPB to next morning, but in the Post-Group was decreased three hours after theCPB （p<0.05）. In conclusion, these fi ndings showed that Sivelestat reduced the infl ammatory reaction associated withcardiopulmonary bypass, and prevented the pulmonary dysfunction caused by infl ammatory reaction.
- 弘前大学の論文
著者
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SUZUKI Yasuyuki
Department of Physics, Faculty of Science, Niigata University
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Fukuda Ikuo
Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine
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Daitoku Kazuyuki
Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine,
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Fukuda Ikuo
Department Of Cardiovascular Surgery Hirosaki University School Of Medicine
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Minakawa Masahito
Department Of Cardiovascular Surgery Hirosaki University School Of Medicine
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FUKUI Kozo
Department of Chemistry, Graduate School of Science, Osaka University
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Suzuki Yasuyuki
Department Of Cardiovascular Surgery Hirosaki University School Of Medicine
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Suzuki Yasuyuki
Department Of Cardiology Nihon University Surugadai Hospital
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Fukui Kozo
Department Of Thoracic And Cardiovascular Surgery Hirosaki University School Of Medicine
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Daitoku Kazuyuki
Department Of Cardiovascular Surgery Hirosaki University School Of Medicine
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Suzuki Yasuyuki
Department Of Anesthesia And Icu National Children's Hospital
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Fukuda Ikuo
Department Of Thoracic And Cardiovascular Surgery Respiratory Medicine And Nephrology Hirosaki University Graduate School Of Medicine
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FUKUDA Wakako
Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine
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