Aspirin preserves neutrophil apoptosis after cardiopulmonary bypass
Aspirin preserves neutrophil apoptosis after cardiopulmonary bypass
复制标题
DOI：
10.1097/01.shk.0000126146.94237.92
复制
发表时间：
2004-06-01
期刊：
影响因子：
3.1
通讯作者：
Buggy, DJ
中科院分区：
文献类型：
--
作者：
Bates, JJ;Watson, RWG;Buggy, DJ
本研究的目的是检验以下假设：持续的阿司匹林治疗通过环氧合酶机制在体外循环 (CPB) 心脏手术后保留中性粒细胞凋亡。 20 名接受 CPB 冠状动脉血运重建的患者被纳入一项前瞻性队列研究。将一直服用 300 毫克阿司匹林直至手术前一天的患者 (n = 10) 与 10 名未服用阿司匹林或在手术前停止服用阿司匹林超过 5 天的患者进行比较。在手术前和手术后 6 小时从动脉血中分离中性粒细胞，并在培养 24 小时后使用流式细胞术测量细胞凋亡。收集血清并通过酶联免疫吸附测定评估IL-6、IL-8和PGE(2)。术后7天对患者脓毒症临床指标进行随访。与术前样本相比，术后中性粒细胞凋亡的自发率显着降低。阿司匹林和对照术前中性粒细胞凋亡率没有差异（23.0% +/- 11.3% vs. 23.0% +/- 20.7%，P = 0.99）。对照组患者术后中性粒细胞凋亡延迟（3.6% +/- 1.2% 细胞凋亡），但阿司匹林治疗组的情况显着逆转（P = 0.045）（7.2% +/- 5.1% 细胞凋亡）。阿司匹林组术后 PGE(2) 水平较低（136 +/- 69 pg/mL vs. 372 +/- 210 pg/mL，P= 0.04）。脓毒症的临床指标没有差异。我们的结论是，手术前一天服用 300 毫克阿司匹林的患者可以显着保留术后中性粒细胞凋亡的延迟。这与 PGE(2) 的更大抑制有关，与阿司匹林通过环氧合酶介导的机制对 CPB 后细胞凋亡发挥作用的假设一致。
The aim of this study was to test the hypothesis that ongoing aspirin therapy preserves neutrophil apoptosis after cardiac surgery with cardiopulmonary bypass (CPB) by a cyclooxygenase mechanism. Twenty patients undergoing coronary revascularization with CPB were enrolled in a prospective cohort study. Patients who had continued taking 300 mg of aspirin until the day before surgery (n = 10) were compared with 10 patients not taking aspirin or who had discontinued it more than 5 days before surgery. Neutrophils were isolated from arterial blood before and 6 h after surgery and apoptosis was measured after 24 h in culture using flow cytometry. Serum was collected and assessed for IL-6, IL-8 and PGE(2) by enzyme-linked immunoabsorbant assay. Patients were followed for clinical indices of sepsis for 7 days postoperatively. Spontaneous rates of neutrophil apoptosis were significantly reduced in postoperative compared with preoperative samples. There was no difference between aspirin and control preoperative neutrophil apoptosis rates (23.0% +/- 11.3% vs. 23.0% +/- 20.7%, P = 0.99). Postoperative neutrophil apoptosis was delayed in control patients (3.6% +/- 1.2% apoptosis), but this was significantly (P = 0.045) reversed in the aspirin-treated group (7.2% +/- 5.1% apoptosis). There were lower postoperative PGE(2) levels in the aspirin group (136 +/- 69 pg/mL vs. 372 +/- 210 pg/mL, P= 0.04). There was no difference in clinical indices of sepsis. We conclude that the delay in postoperative neutrophil apoptosis is significantly preserved in patients taking 300 mg of aspirin on the day before surgery. This was associated with greater inhibition of PGE(2), consistent with the hypothesis that aspirin exerts its effect on apoptosis after CPB via a cyclooxygenase-mediated mechanism.