体外循环患者尿中血栓素B2代谢产物的研究。

Eicosanoids Pub Date : 1992-01-01
A Jörres, C Chiabrando, O Kordonouri, A Schiessler, S Hess, S Farke, G M Gahl, C Müller, L Rivoltella, R Djurup
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引用次数: 0

摘要

本文研究了16例体外循环(CPB)患者尿中肾损伤标志物和血栓素代谢物的排泄情况。CPB后第1天,小管和肾小球标志物的排泄量急剧增加,并在整个观察期(5天)保持升高。直接酶免疫法测定免疫反应性血栓素B2 (i-TXB2,主要反映2,3-dinor- txb2)和免疫反应性11-酮-血栓素B2 (i-11-酮- txb2)。采用气相色谱-质谱法测定所选样品中的TXB2、2,3-dino -TXB2和11-keto-TXB2。i-TXB2和i-11-酮- txb2的尿排泄率在术后第1天显著升高,随后下降。CPB后,2,3-dinor-TXB2和TXB2的排泄率呈现平行变化,表明这些患者尿液中大多数TXB2来自血小板而不是肾脏。综上所述,我们的观察结果不支持CPB后观察到的急性肾损伤是由肾脏中过量的血栓素生物合成引起的假设。
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Thromboxane B2 urinary metabolites in patients undergoing cardiopulmonary bypass.

The urinary excretion of selected markers for renal injury and thromboxane metabolites was studied in 16 patients undergoing cardiopulmonary bypass (CPB). Excretion of both tubular and glomerular markers sharply increased on day 1 after CPB and remained elevated throughout the observation period (five days). Immunoreactive thromboxane B2 (i-TXB2, mainly reflecting 2,3-dinor-TXB2) and immunoreactive 11-keto-thromboxane B2 (i-11-keto-TXB2) were measured by direct enzyme immunoassays. TXB2, 2,3-dinor-TXB2 and 11-keto-TXB2 were also measured in selected samples by GC-MS. Urinary excretion rates of both i-TXB2 and i-11-keto-TXB2 markedly increased on day 1 after surgery and decreased thereafter. Following CPB, excretion rates of 2,3-dinor-TXB2 and TXB2 displayed parallel changes, suggesting that in these patients most urinary TXB2 derives from blood platelets rather than the kidney. Taken together, our observations do not support the hypothesis that acute renal injury observed after CPB is caused by exaggerated thromboxane biosynthesis in the kidney.

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