アプロチニンは,心肺バイパスによる血小板機能不全を予防します. スキャニング電子顕微鏡の研究
1Department of Cardiac Surgery and Epidemiology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Circulation
|November 1, 1992
まとめ
心肺バイパス中にアプロチニンを投与すると,血小板機能が著しく保たれ,失血が軽減されます. 高用量のアプロチニンは,低用量またはプラセボと比較して,より優れた血小板の保護と術後の血静の改善を示しました.
科学分野:
- 心血管外科手術についてです.
- 血液学 ヘマトロジ
- 薬理学 薬理学とは
背景:
- アプロチニンは,血液の損失を軽減し,体外循環中の血小板機能を改善することが知られている.
- 血小板機能不全は,心肺バイパス手術中の懸念事項です.
研究 の 目的:
- 心肺バイパス手術中の血小板機能に対するアプロチニンの保護効果を評価する.
- 高用量の連続アプロチニンと低用量のボルスアプロチニンとプラセボの有効性を比較する.
主な方法:
- 心肺バイパス手術を受けた50人の患者は,高用量のアプロチニン,低用量のアプロチニン,プラセボという3つのグループにランダムに分けられました.
- 血小板の集積は,スキャニング電子顕微鏡を用いて評価され,1から4に格付けされました.
- 輸血後の失血,血小板数,輸血された赤血球単位,および同型血液製品が測定されました.
主要な成果:
- 高用量アプロチニン (Aグループ) は,低用量 (Bグループ,平均グレード2.9) とプラセボ (Cグループ,平均グレード1.4) と比較して,著しく優れた血小板集積 (平均グレード3.4) を維持しました.
- Aグループは,Bグループ (488ミリ) とCグループ (780ミリ) よりも,著しく少ない血流 (395ミリ) を経験しました.
- アプロチニンを投与された患者は,プラセボ群と比較して,赤血球単位と同質の血液製品が少ない必要がありました.
結論:
- アプロチニンは,心肺バイパス手術中に血小板機能を効果的に保ちます.
- 高用量のアプロチニンの投与は,手術後の血液静止を改善し,輸血の必要性を減少させます.
- アプロチニンは,心臓手術における血小板機能不全とそれに関連する出血合併症を緩和するのに有益です.
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