Lipo-PGE1对心脏瓣膜置换术围体外循环期血小板功能的影响  

Effects of liposomal prostaglandin E1 on platelets function during and after cardiopulmonary bypass

作　　者：李明颖[1] 潘晓军[2] 张晓霞[1] 李洁[1] 王振元[1] 

机构地区：[1]首都医科大学附属北京朝阳医院京西院区,北京100043 [2]山东大学齐鲁医院

出　　处：《山东医药》2009年第52期28-30,共3页Shandong Medical Journal

摘　　要：目的探讨前列腺素E1脂微球载体制剂(Lipo-PGE1)对围体外循环(CPB)期血小板功能的影响。方法选择20例择期CPB下行心脏瓣膜置换术的患者,随机分为两组。观察组于麻醉诱导后至CPB结束匀速泵入Lipo-PGE1,速度为10 ng/(kg.min),预充液中加入10 ng/ml Lipo-PGE1;对照组给予相同容量的生理盐水。于诱导后即刻(T1),CPB开始30 min(T2),CPB结束即刻(T3),CPB后1 h(T4)、2 h(T5)、24 h(T6)分别采集外周动脉血测定血浆α-颗粒膜蛋白-140(GMP-140)、血小板最大聚集率(MAR)及血小板计数(PLT)。结果CPB开始至CPB结束后早期两组MAR均显著下降而GMP-140水平显著升高,观察组MAR及GMP-140水平均明显低于对照组(P<0.05),并于CPB结束后24 h均恢复至术前水平;CPB开始至CPB结束后24 h两组PLT均较术前明显下降(P<0.01),对照组下降更明显,但无统计学差异(P>0.05)。结论Lipo-PGE1在CPB过程中能有效减少血小板激活,保护血小板功能。Objective To investigate the effects of liposomal prostaglandin E1(Lipo-PGE1) on platelets function during and after cardiopulmonary bypass(CPB).Methods Twenty patients received cardiac valve replacement undergoing CPB were randomized divided into the observe group and control group.The patients of the observe group were administered 10 ng/(kg·min) of Lipo-PGE1 from induction of anesthesia till the end of CPB and some other Lipo-PGE1 was added to the priming solution(10 ng/ml).Normal saline was given to the control group patients.Peripheral arterial blood was collected to detect α-granule membrane protein-140(GMP-140),platelet count and the maximum platelet aggregation rate(MAR) at immediately after anesthesia induction(T1),30 minutes after beginning of CPB(T2),the end of CPB(T3) and 1 hour(T4),2 hours(T5),24 hours(T6) after the end of CPB.Results The plasma level of GMP-140 increased and MAR decreased obviously from the beginning of CPB to the early period after CPB in both groups.Both of GMP-140 and MAR were significantly higher in the control group than those in the observe group.The platelet count significantly decreased from the beginning to 24 hours after CPB in both groups,but no remarkable difference between two groups.Conclusion Lipo-PGE1 can protect platelets from unwanted activation during and after CPB.

关 键 词：前列腺素E脂微球载体制剂 体外循环 α-颗粒膜蛋白-140 血小板最大聚集率 

分 类 号：R614.2[医药卫生—麻醉学]