体外循环期间血浆D-二聚体的变化  

Study of Plasma Ddimer During Cardiopulmonary Bypass

作　　者：王庆善[1] 张荣振 徐大庆[1] 陈世洁[1] 王文生[1] 王琰[1] 

机构地区：[1]中国医科大学第二临床学院体外循环组

出　　处：《中华胸心血管外科杂志》1998年第1期4-6,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：观察心内直视手术病人体外循环（ＣＰＢ）前后血浆Ｄ－二聚体（Ｄ－Ｄ）的变化，了解其临床意义，应用国产单克隆抗体、ＥＬＩＳＡ法对４５例ＣＰＢ病人分别在全身肝素化后、转流８分钟和转流结束１０分钟时检测Ｄ－Ｄ、ＨＣＴ、ＡＣＴ。结果：ＣＰＢ中和ＣＰＢ后Ｄ－Ｄ明显升高，显示继发性纤溶活性增强，并与转流时间成正比（Ｐ＜０．０１），故应尽可能缩短ＣＰＢ时间。Ｄ－Ｄ检测可做为ＣＰＢ导致的ＤＩＣ与术后外科性出血的鉴别诊断方法之一。Aim:To study the changes and clinical significance of plasma Ddimer during cardiopulmonary bypass (CPB).Clinical material and method:Plasma Ddimer was studied in 45 patients using ELISA method during open heart surgery under CPB.Blood samples were taken at four different time intervals.HCT and ACT were measured simultaneously. Result:The content of plasma D dimer increased from 0.279mg/L to 5.5mg/L during CPB (p<0.01).The level of plasma Ddimer was 4.04 mg/L when CPB time <60 minutes.It increased to 5.26 mg/L when CPB time >60 minutes and <120 minutes.However,when CPB time >120 minutes it reached 9.01 mg/L. Conclusion:The elevation of plasma Ddimer is closely related to cardiopulmonary bypass,especially related to the duration of CPB.It could result in secondary hyperfibrinolysis.

关 键 词：体外循环 D-二聚体 心内直视手术 

分 类 号：R654.1[医药卫生—外科学]