The relations of lung injury after cardiopulmonary bypass and infl ammatory reaction, especially neutrophil elastase

フォーマット:

論文

責任表示:

Suzuki, Yasuyuki ; Daitoku, Kazuyuki ; Minakawa, Masahito ; Fukui, Kozo ; Fukuda, Ikuo

言語:

英語

出版情報:

弘前大学大学院医学研究科・弘前医学会, 2007-11-29

著者名:

• Suzuki, Yasuyuki
• Daitoku, Kazuyuki
• Minakawa, Masahito
• Fukui, Kozo
• Fukuda, Ikuo

掲載情報:

弘前医学

ISSN:

0439-1721      

巻:

59

通号:

Supplement

開始ページ:

S147

終了ページ:

S153

バージョン:

publisher

概要:

We have proved that Sivelestat preserved lung function after cardiopulmonary bypass（ CPB） in the rabbit model. We now report the therapeutic efficacy of Sivelestat in the clinical case. From July 2005, 16 patients who underwent aortic arc … h replacements were enrolled in this study. Diagnosis included dissected aortic aneurysm in 6 patients, true aortic arch aneurysm in 8, and traumatic aortic arch aneurysm in 1 patient. We randomly divided these patients into two groups. In the Pre-Group（ Pre:n=8）, infusion of Sivelestat（ 0.2mg/kg/hr） was started before the operation; 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 were measured before the operation, at one and three hours after the CPB and the next morning. Because the preoperative P/F ratio（ arterial PO2/FiO2） varies with each case, the value of the P/F ratio at one hour after the CPB was calculated for 100%. Elastase activity of both groups were increased at the end of CPB（ Pre:8.9±10.6, Post:4.6± 3.5）, then returned to baseline level at end of operation（ NS）. IL-8 of both groups were increased at end of CPB, then in the Pre-Group decreased 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 the CPB （p<0.05）. In conclusion, these fi ndings showed that Sivelestat reduced the infl ammatory reaction associated with cardiopulmonary bypass, and prevented the pulmonary dysfunction caused by infl ammatory reaction. 続きを見る

URL:

http://hdl.handle.net/10129/2229