[Effects of aprotinin on TNF-alpha levels after cardiopulmonary bypass].
OBJECTIVE
This study evaluates the anti-inflammatory activity of full-dose and pump-prime-only(low-dose) aprotinin by means of comparing tumor necrosis factor alpha(TNF-alpha) levels of both groups after CPB.


METHODS
Twenty-nine adults with rheumatic heart disease were randomized into three groups: (1) full-dose aprotinin-treated group(Group A, n = 10); (2) pump-prime-only aprotinin-treated group(Group B, n = 10), and (3) control group(Group C, n = 9). Plasma concentrations of TNF-alpha were measured by enzyme-linked immunosorbent assay technique at baseline(before operation), and at 2, 24 hours after CPB termination.


RESULTS
A significant(P < 0.05) increase of TNF-alpha occurred in all three groups at 2 and 24 hours after CPB termination when compared with the same group at baseline. In Group A, TNF-alpha level was significantly lower than that in group C(P < 0.05) at 24 hours after CPB, but not in group B(P > 0.05).


CONCLUSIONS
Both CPB and operative stimulus induce the increase of cytokine TNF-alpha after CPB. Full-dose aprotinin has the anti-inflammatory effect by means of reducing TNF-alpha level after CPB. Low-dose aprotinin dose not reduce TNF-alpha level. So it no significant anti-inflammatory effect.
Liu
L M
LM
Department of Cardiothoracic Surgery, Second Affiliated Hospital, Hunan Medical University, Changsha 410011.
Hu
J G
JG
Xu
M
M
D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D007611:Aprotinin / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012214:Rheumatic Heart Disease / Q000188:drug therapy / Q000601:surgery*; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D014409:Tumor Necrosis Factor-alpha; D007611:Aprotinin