Integrilin prevents prolonged bleeding times after cardiopulmonary bypass.
Integrilin prevents prolonged bleeding times after cardiopulmonary bypass.
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Integrilin 可防止体外循环后出血时间延长。
DOI：
10.1016/s0003-4975(98)00527-x
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
EdmundsJr,LH
中科院分区：
文献类型：
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作者：
Suzuki,Y;Hillyer,P;Miyamoto,S;Niewiarowski,S;Sun,L;Rao,AK;Hollenbach,S;EdmundsJr,LH
心脏搭桥术降低了血小板数量和功能，增加了术后出血时间，是心脏直视手术后非手术出血的主要原因。在心肺转流（血小板麻醉）保护血小板，减少术后出血时间和bleeding.MethodsIntegrilin，短效，可逆的血小板糖蛋白IIb/IIIa抑制剂的血小板功能的暂时抑制在28狒狒有60分钟的常温心肺转流使用外周插管进行了研究。研究了对照组、接受不同剂量Integrilin的两组和接受Integrilin和低剂量伊洛前列素组合的一组。在7个时间点采集用于血小板计数、腺苷二磷酸聚集、β-血栓球蛋白、凝血酶原片段F1.2、凝血酶-抗凝血酶复合物和纤维蛋白肽A的血样。模板出血时间进行测量之前，并在5个间隔后，心肺bypass. ResultsTwo剂量的Integrilin和Integrilin和伊洛前列素的组合显着保护血小板数量，抑制反应腺苷二磷酸，并减少术后出血时间，但他们没有减少β-血小板球蛋白的释放，除了在高剂量的Integrilin组。在所有治疗组中，凝血酶形成和活性均定性降低，但不显著。出血时间没有显着不同，从基线的时间鱼精蛋白在组合组和鱼精蛋白给药后60分钟，在所有treatment group.ConclusionsIntegrilin单独或与伊洛前列素联合显着降低血小板活化在心肺转流术，并产生正常或接近正常的出血时间鱼精蛋白的时间。
BackgroundCardiopulmonary bypass reduces platelet number and function, increases postoperative bleeding time, and is the major, unsolved cause of nonsurgical bleeding after open heart operations. Temporary inhibition of platelet function during cardiopulmonary bypass (platelet anesthesia) protects platelets and reduces postoperative bleeding time and bleeding.MethodsIntegrilin, a short-acting, reversible platelet glycoprotein IIb/IIIa inhibitor was studied in 28 baboons that had 60 minutes of normothermic cardiopulmonary bypass using peripheral cannulas. A control group, two groups that received different doses of Integrilin, and a group that received a combination of Integrilin and low-dose Iloprost were studied. Blood samples for platelet count, aggregation to adenosine diphosphate, β-thromboglobulin, prothrombin fragment F1.2, thrombin-antithrombin complex, and fibrinopeptide A were obtained at seven time points. Template bleeding times were measured before and at five intervals after cardiopulmonary bypass.ResultsBoth doses of Integrilin and the combination of Integrilin and Iloprost significantly protected platelet number, inhibited the response to adenosine diphosphate, and reduced postoperative bleeding times, but they did not reduce β-thromboglobulin release except in the high-dose Integrilin group. Thrombin formation and activity were qualitatively, but not significantly, reduced in all treatment groups. Bleeding times were not significantly different from baseline at the time protamine was given in the combination group and 60 minutes after protamine administration in all treatment groups.ConclusionsIntegrilin alone or in combination with Iloprost significantly reduces platelet activation during cardiopulmonary bypass and produces normal or near-normal bleeding times at the time protamine is given.