不同取代级羟乙基淀粉对健康成人血小板功能的影响  

Effect of hydroxyethyl starch molecules with different degrees of substitution on platelet membrane glycoprotein function in vitro

作　　者：隋波[1] 谢厚云[1] 苏冬梅[1] 马玉恒[1] 田雷[1] 孙潮涌[1] 王维[1] 马涛[1] 

机构地区：[1]第二炮兵总医院麻醉科,北京市100088

出　　处：《临床麻醉学杂志》2008年第10期861-863,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨羟乙基淀粉200/0.5与羟乙基淀粉130/0.4对血小板表面的粘附作用和对血小板膜糖蛋白的影响。方法用经过荧光素异硫氰酸盐标记的羟乙基淀粉200/0.5(Ⅰ组)分别将20位健康供血者的血液稀释成0%、5%、10%、20%、30%和40%浓度亚组,用流式细胞仪测定被羟乙基淀粉200/0.5粘附的血小板的百分数和血小板活性的变化,以判断羟乙基淀粉200/0.5粘附血小板的程度和对血小板功能的影响。同时与羟乙基淀粉130/0.4(Ⅱ组)相同稀释浓度亚组比较。结果被荧光素异硫氰酸盐标记的羟乙基淀粉200/0.5粘附血小板的百分数在10%稀释组开始呈浓度依赖模式增加(P<0.05),对血小板膜糖蛋白Ⅱb-Ⅲa的减少作用也在10%稀释组开始呈浓度依赖模式增加(P<0.05),而不同稀释浓度的羟乙基淀粉130/0.4对血小板粘附与活性均无影响。结论羟乙基淀粉200/0.5的10%以上稀释组对血小板表面过多的粘附可以通过阻碍血小板膜糖蛋白的活性影响血小板功能,而羟乙基淀粉130/0.4不同的稀释浓度对血小板功能均无影响。Objective To study the effect of hydroxyethyl starch （HES） molecules with different degrees of substitution on platelet membrane glycoprotein function in vitro. Methods Citrated whole blood samples from 20 yolunreers were hemodiluted with fluorescein isothiocyanate （FITC） -labled HES 200/0. 5 by 0 %, 5 %, 10 %,20 %, 30 % and 40 %, respectively. The percentage of platelets binding FITC-HES 200/0.5 and the expression of membrane glycoprotein Ⅱb-Ⅲa on activated platelets were determined using whole blood flow eytometry. The results were compared with those hemodiluted by HES 130/0.4. Results The percentage of FITC positive platelets was increased and glyeoprotein Ⅱ b- Ⅲ a expression reduced in a concentration-dependent manner when the hemodilution was at 10 %or more （P〈0.05）, which was not when the blood was diluted with HES 130/0. 4. Conclusion Extracellular binding of HES 200/0. 5 on platelets surface is responsible for its antiplatelet effects by decreased availability of platelet glycoprotein Ⅱ b-Ⅲ a expression.

关 键 词：羟乙基淀粉 血小板 糖蛋白 

分 类 号：R614[医药卫生—麻醉学]