摘要：目的研究CPB的肺损伤和抑肽酶的肺保护作用。方法 选择24例患者随机分为两组(各12例)，实验组在体外循环机中加入抑肽酶10万KIU/Kg；对照组则不用抑肽酶。动态检测两组患者左右房中性粒细胞(PMN)、血小板(Pt)、IL-6、IL-10、TNF-α、肺泡氧合指数(OI)。结果 两组转流前左、右房PMN、Pt无显著差异，对照组主动脉开放心脏复跳后5分钟检测左房PMN、Pt明显低于右房(P<0.05)；实验组左、右心房血中PMN、Pt无明显差异(P>0.05)。CPB开始后，两组桡动脉血IL-6、IL-10、TNF-α进行性增高，对照组IL-6、TNF-α增高更显著(P<0.05)。实验组IL-10增高更显著(P<0.05)。 CPB后实验组患者肺泡氧合指数(OI)明显低于对照组(P<0.05)。结论 抑肽酶能通过保护血小板，抑制炎症因子IL-6、TNF-α的产生，并能加速抗炎因子IL-10的释放，从而抑制白细胞的激活、肺内聚集和扣留，减轻体外循环后肺损伤和通气功能障碍，改善术后肺功能。

    关键词：抑肽酶；体外循环；肺保护；

    Protective Effect of Aprotinin on Lungs in Cardiopulmonary Bypass Patients

    WEI Lei，LIU Biao，LIANG Yong-nian，CHEN Yi-jiang

    (Department of Cardiac Surgery，The First Affiliated Hospital of Nanjing Medical University， Jiangsu 210029,China)

    Abstract: OBJECTIVE To evaluate the protective effect of aprotinin on lungs in cardiopulmonary bypass(CPB) patients. METHODS 24 patients undergoing open-heart surgery under CPB were randomly divided into two groups: control group and test group.The test group received the aprotinin. PMN and platelet(Pt) count, interleukin-6(IL-6) , interleukin-10(IL-10), tumor necrosis factor-α(TNF-α) and alveolar oxygenation index(OI) were recorded perioperatively in both groups.RESULTS PMN and Pt counts in the left atrial blood were significantly lower than that in the right atrium 5 min after aorta was unclamped in the control group(P<0.05). The plasma levels of IL-6 and TNF-α in the test group were significantly lower than the control group(P<0.05) .IL-10 in the test group increased compared with the control group(P<0.05) .OI in the control group was significantly higher than in the test group.CONCLUSION Aprotinin could protect lungs during cardiopulmonary bypass. ......