Protamine: A Review of its Toxicity
Protamine: A Review of its Toxicity
复制标题
鱼精蛋白：毒性回顾
作者：
J. Horrow
上述前瞻性人体研究表明，在某些患者中，鱼精蛋白与 SBP 和 SVR 降低相关，特别是在快速给药时。心输出量会反射性地增加，但心室顺应性较差的患者除外，这些患者更依赖于前负荷来维持每搏输出量。在后者中，与鱼精蛋白相关的充盈量减少可以降低 CO。无论给药速率如何，鱼精蛋白都不会产生可预测的 PAP 急剧增加，尽管在特异质反应期间可能会出现 PAP 增加（请参阅下面有关特异质反应的部分）。左心房或主动脉给予鱼精蛋白可能无法避免其血流动力学或特殊后遗症（见下文）。几乎没有证据表明鱼精蛋白会直接抑制人类心脏的收缩力。
The prospective human studies considered above reveal that in some patients protamine is associated with decreases in SBP and SVR, especially when administered rapidly. Cardiac output increases reflexly, except perhaps in patients with less compliant ventricles, which are more dependent on preload to maintain stroke volume. In the latter, decreases in filling volume associated with protamine can lower CO. Regardless of the rate of administration, protamine does not produce predictable, acute increases in PAP, although increases in PAP may occur during idiosyncratic reactions (see the section on idiosyncratic reactions below). Left atrial or aortic administration of protamine may not confer protection from its hemodynamic or idiosyncratic sequelae (see below). Little evidence exists to conclude that protamine directly depresses contractility of the human heart.