体外循环致肺内血小板聚集与血栓素、前列环素代谢变化及其意义  

Significance of changes in thromboxane-prostacyclin synthesis and platelet aggregation in lung following cardiopulmonary bypass

作　　者：李增棋[1] 廖崇先[1] 林艳娟[1] 吕联煌[1] 

机构地区：[1]福建医科大学附属协和医院,福州350001

出　　处：《中华实验外科杂志》1998年第2期130-131,共2页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨体外循环肺损伤与肺内血小板聚集及血栓素、前列环素代谢变化之间的关系。方法 比较16例心内直视手术病人肝素化前、复跳后10分钟、45分钟、2小时左右心房血血小板数、血栓素B2(TXB2)及6-酮-前列腺素F1α(6-Kero-PGF1α)指标的变化。结果 肺再灌注早期有明显的血小板肺内扣押现象，以及肺内TXB2生成增加与TXB2／6-Kero-PGF1α比值明显升高(P＜0．05～001)。结论 肺内血小板聚集、血栓素生成异常增加及血栓素/前列环素平衡失调在灌注肺的发生中起着重要作用。Objective To detect the relationship between the lung injury following cardiopulmonary bypass (CPB) and the changes in thromboxane-prostacyclin synthesis, platelet aggregation in lung. Method Sixteen patients undergoing open heart operation with CPB were investigated. Blood samples were taken from the left and rigm atrium before CPB and 10 min, 45 min, 2 h after release of the aortic cross-clamp to determine platelet count, thromboxane B_2 (TXBZ_2) and 6-keto-prostaglandin F_1a (6-keto-PGF_la). The levels before CPB were compared with ones after release of the aortic cross-clamp. Result The results showed that the platelet aggregation, the significant increase ill the TXB2 production and the ratio of TXB_2/6-keto-PGF_la (P<0.05~0.0l) were detected in the early phase of the pulmonary reperfusion. Conclusion These results suggested that the platelet aggregation in lung, the abnomal increase in the thromboxane production and the imbalance in the thromboxane/prostacyclin might play important roles in the induction of lung injury following CPB.

关 键 词：血小板聚集 前列环素 体外循环 代谢变化 肺内 6-酮-前列腺素F1α 血栓素B2(TXB2) 其意义 PGF1α 手术病人 心内直视 血小板数 0.05 平衡失调 肺损伤 肝素化 右心房 再灌注 α比值 灌注肺 

分 类 号：R285.5[医药卫生—中药学] R541.4[医药卫生—中医学]