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探讨大剂量甲泼尼松龙（ＭＰＳＳ）对肺再灌注早期血小板聚集、血栓素生成的抑制作用。方法将３０例体外循环心脏手术患者随机分成对照组与ＭＰＳＳ用药组，各１５例。用药组于体外循环前静注ＭＰＳＳ１５ｍｇ／ｋｇ体重。３０例患者分别于体外循环前、复跳后１０、４５分钟、２小时抽左右心房血，检测血小板数、ＴＸＢ２及６－ｋｅｔｏ－ＰＧＦ１αｏ。结果对照组复跳后各时相左房血血小板数明显比右房者低（Ｐ＜０．０５），左房血ＴＸＢ２含量明显比右房者高（Ｐ＜０．０１）；而用药组复跳后左、右房血血小板数、ＴＸＢ２差异无显著意义。用药组并能明显降低复跳后ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值（Ｐ＜０．０５～０．０１）。结论大剂量ＭＰＳＳ对肺再灌注早期血小板聚集有明显抑制作用，减少肺内血栓素生成，降低血栓素／前列环素比值，起到预防或减少灌注肺发生的作用。
To investigate the inhibitory effect of high dose methylprednisolone (MPSS) on platelet aggregation and thromboxane production during early reperfusion of lung. Methods Thirty patients with cardiopulmonary bypass were randomly divided into control group and MPSS group, 15 cases each. The medication group was intravenously injected with MPSS15mg / kg body weight before cardiopulmonary bypass. 30 patients before cardiopulmonary bypass, 10,45 minutes after rebound, 2 hours left and right atrial blood pumping, detection of platelet count, TXB2 and 6-keto-PGF1αo. Results Compared with the right atrium, the left atrial blood TXB2 level in the left atrium was significantly higher than that in the right atrium in the control group (P <0.05) Jump left and right atrial blood platelet number, TXB2 no significant difference. The treatment group also significantly reduced TXB2 / 6-keto-PGF1α ratio (P <0.05 ~ 0.01). Conclusion High-dose MPSS can significantly inhibit platelet aggregation during early reperfusion, reduce thromboxane production and decrease the ratio of thromboxan / prostacyclin in the lung to prevent or reduce the incidence of pulmonary perfusion.