Platelet anesthesia with nitric oxide with or without eptifibatide during cardiopulmonary bypass in baboons.
Platelet anesthesia with nitric oxide with or without eptifibatide during cardiopulmonary bypass in baboons.
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DOI：
10.1016/s0022-5223(99)70380-6
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发表时间：
1999-05
期刊：
影响因子：
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通讯作者：
Yasuyuki Suzuki;Ramin Malekan;C.William Hanson;S. Niewiarowski;Ling Sun;A. Rao;L. Henry Edmunds
中科院分区：
文献类型：
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作者：
Yasuyuki Suzuki;Ramin Malekan;C.William Hanson;S. Niewiarowski;Ling Sun;A. Rao;L. Henry Edmunds
本研究验证了一氧化氮或一氧化氮与依替巴肽（Integrilin）可逆地抑制体外循环期间血小板活化和消耗，并在体外循环后迅速恢复血小板数量和功能。在21只狒狒中进行了60分钟的常温体外循环，使用外周插管。研究了对照组、接受80 ppm一氧化氮的组和接受一氧化氮和依替巴肽的组。在几个时间点采集血样，以测定血小板计数、对二磷酸腺苷的反应性聚集以及β-凝血球蛋白、凝血酶原片段1.2和凝血酶-抗凝血酶复合物的水平。模板出血时间测定前，在4个间隔后，心肺bypass.ResultsBoth一氧化氮和2种药物的组合显着衰减血小板消耗，改善postbypass功能，并减少血浆β-thromboglobulin释放相对于对照组动物的值。在心肺转流结束后55分钟，一氧化氮和联合用药均恢复了基线出血时间。一氧化氮和组合之间没有显着差异被发现为任何measurement. ConclusionNO或没有eptifibatide保护血小板在体外循环和加速恢复正常出血时间后，在狒狒模型。尽管一氧化氮和依替巴肽通过不同的机制可逆地抑制血小板，但在没有伤口的情况下，没有证实协同作用。（《胸血管外科杂志》1999;117：987-93）
ObjectiveThis study tested the hypothesis that nitric oxide or nitric oxide and eptifibatide (Integrilin) reversibly inhibit platelet activation and consumption during cardiopulmonary bypass and rapidly restore platelet numbers and function after bypass.MethodsNitric oxide, a short-acting, reversible platelet inhibitor, was studied with and without eptifibatide, a short-acting, reversible glycoprotein IIb/IIIa inhibitor, in 21 baboons that underwent 60 minutes of normothermic cardiopulmonary bypass with peripheral cannulas. A control group, a group that received 80 ppm nitric oxide, and a group that received both nitric oxide and eptifibatide were studied. Blood samples were obtained at several time points to determine platelet count, aggregation in response to adenosine diphosphate, and levels of β-thromboglobulin, prothrombin fragment 1.2, and thrombin-antithrombin complex. Template bleeding times were measured before and at 4 intervals after cardiopulmonary bypass.ResultsBoth nitric oxide and the combination of the 2 drugs significantly attenuated platelet consumption, improved postbypass function, and reduced plasma β-thromboglobulin release with respect to values in control animals. Both nitric oxide and the combination restored baseline bleeding times 55 minutes after cardiopulmonary bypass ended. No significant differences between nitric oxide and the combination were found for any measurement.ConclusionNitric oxide with or without eptifibatide protects platelets during cardiopulmonary bypass and accelerates restoration of normal bleeding times after operation in a baboon model. Although nitric oxide and eptifibatide reversibly inhibit platelets by different mechanisms, in the absence of a wound no synergistic effect was demonstrated. (J Thorac Cardiovasc Surg 1999;117: 987-93)