[Usefulness of allopurinol for prevention of myocardial reperfusion injury in open heart surgery].
Xanthine oxidase has been demonstrated to be an important factor in postischemic reperfusion injury. Allopurinol is the inhibitor of xanthine oxidase. In this study, we evaluated usefulness of allopurinol for prevention of myocardial reperfusion injury in open heart surgery. Twenty adult patients were divided into two groups; Ap-group (n = 10) were administered allopurinol for seven days just before operation and control-group (n = 10) were administered nothing. The dose of allopurinol was ranged 100-300 mg/day. The dose was determined according to renal function of patients. Coronary sinus blood hypoxanthine, xanthine, uric acid, lactate, pyruvate, CK, and CK-MB levels were measured at before CPB, 5 and 15 min. after aortic declamping, 5 min. after CPB. Hypoxanthine and xanthine levels in Ap-group were significantly higher than those in control-group at 5 and 15 min. after aortic declamping, 5 min. after CPB. Uric acid levels in Ap-group were significantly lower than those in control-group at 5 and 15 min. after aortic declamping, 5 min. after CPB. Lactate, pyruvate, CK, and CK-MB levels were not different between Ap-group and control group. We considered that allopurinol suppressed the reaction rate of xanthine oxidase. Therefore, the levels of intermediates, hypoxanthine and xanthine, were high and, the level of final product, uric acid was low in Ap-group. However, allopurinol had no efficacy for the level of lactate, pyruvate, CK, and CK-MB, in this study.
Yamazaki
I
I
Department of Cardiovascular Surgery, Nanbu Hospital, Kanagawa, Japan.
Soma
T
T
Ichikawa
Y
Y
Iwai
Y
Y
Kondo
J
J
Matsumoto
A
A
D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use*; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009206:Myocardium / Q000201:enzymology; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors / Q000096:biosynthesis
D007527:Isoenzymes; D000493:Allopurinol; D014969:Xanthine Oxidase; D003402:Creatine Kinase