[Randomized controlled trial for the effect of amrinone and aprotinin on expression leukocyte adhesion molecule in patients with prosthetic valve replacement during perioperative period].
OBJECTIVE
To explore the effect of amrinone and aprotinin on expression of leukocyte adhesion molecule in patients with prosthetic valve replacement during perioperative period.


METHODS
Thirty-two patients undergoing valve replacement were randomized to control group, the first aprotinin group, the second aprotinin group, and amrinone combined with aprotinin group; each group consisted of eight cases. In the first aprotinin group, 3 x 10(6) units of aprotinin was added to the priming solution of the extracorporeal circulation (ECC). In the second aprotinin group, 3 x 10(6) units of aprotinin was added to the priming solution of ECC, which was combined with 1 x 10(6) units of aprotinin for intravenous bolus. In the amrinone combined with aprotinin group, 3 x 10(6) units aprotinin was added to the priming solution of the ECC and amrinone began with a bolus of 1 mg/kg followed by a maintenance intrusion of 8 micrograms/kg.min. The control group received an equivalence without aprotinin. Venous blood samples were drawn before the operation, at the end of the ECC, 1 hour after the end of the ECC, and one day after the operation, respectively. Flow cytometry was used to demonstrate the expression of leukocyte adhesion molecule CD11b/CD18.


RESULTS
Before ECC, there were no differences of the levels of CD11b+/CD18+ in all groups (P > 0.05). One hour after the ECC, the level of CD11b+/CD18+ in group B was lower than that in group A, the level of CD11b+/CD18+ in group C was lower than that in group B, and the level of CD11b+/CD18+ in group D was higher than that in group C, but no significant difference between groups was noted (P > 0.05).


CONCLUSIONS
Although amrinone and aprotinin have anti-inflammatory activity, the pump prime which was added aprotinin alone or aprotinin combined with amrinone might fail in preventing the expression of leukocyte adhesion molecule CD11b/CD18 completely in patients with prosthetic valve replacement during ECC perioperative period.
Cao
Ge
G
Thoracic and Cardiac Surgery Department, West China Hospital, Sichuan University, Chengdu 610041, China.
Luo
Chaozhi
C
Xiao
Xijun
X
Wei
Yuquan
Y
Yin
Defu
D
Zhuang
Xiang
X
Chen
Yixiang
Y
Yun
Heng
H
D000328:Adult; D000676:Amrinone / Q000627:therapeutic use*; D007611:Aprotinin / Q000627:therapeutic use*; D039481:CD11b Antigen / Q000097:blood*; D018821:CD18 Antigens / Q000097:blood*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D005112:Extracorporeal Circulation; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period
D039481:CD11b Antigen; D018821:CD18 Antigens; D002316:Cardiotonic Agents; D007611:Aprotinin; D000676:Amrinone