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

Abstract

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).

Conclusion: 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.