复方电解质注射液对回收红细胞膜Na^+-K^+-ATP酶活性和血液流变学的影响  

Effects of Plasma Lyte A on recovery erythrocyte membrane Na^+-K^+-ATP enzyme activity and hemorheology

作　　者：石英[1] 陶国才[1] 汪玉林[1] 邓玲[1] 

机构地区：[1]第三军医大学第一附属医院麻醉科,重庆市400038

出　　处：《临床麻醉学杂志》2012年第9期888-890,共3页Journal of Clinical Anesthesiology

摘　　要：目的比较复方电解质注射液和复方乳酸钠注射液对回收红细胞膜Na+-K+-ATP酶活性和血液流变学的影响,旨在探讨影响回收血液质量的原因,改良血液回收技术。方法选择骨科或脑外科手术中需行血液回收的患者40例,ASAⅠ或Ⅱ级,随机均分为复方电解质注射液组(A组)和复方乳酸钠注射液组(L组)。检测两组血液回收前、回收后红细胞膜Na+-K+-ATP酶活性、红细胞刚性指数(TK)、红细胞聚集指数(Arbc)、红细胞电泳时间(EPT),检测输注后机体红细胞膜Na+-K+-ATP酶活性。结果与回收前比较,两组回收后、输注后红细胞膜Na+-K+-ATP酶活性均显著降低(P<0.01)。与A组比较,L组回收后红细胞膜Na+-K+-ATP酶活性显著降低(P<0.01),而输注后两组红细胞膜Na+-K+-ATP酶活性差异无统计学意义。与回收前比较,两组回收后红细胞TK均显著升高(P<0.01)。与L组比较,A组回收后红细胞TK明显降低(P<0.05);两组回收前、回收后Arbc值差异无统计学意义。与回收前比较,两组回收后EPT值均缩短,但差异无统计学意义。直线相关分析显示,回收前和回收后红细胞膜Na+-K+-ATP酶活性、TK的变化无显著相关性(L组:r=0.382;A组:r=0.0081)。结论采用复方电解质注射液冲洗回收红细胞可减轻血液回收过程中Na+-K+-ATP酶活性的损害、改善红细胞变形力。改良血液回收冲洗液可能改善回收红细胞质量和血液流变学,促进组织氧供,稳定机体生理环境。Objective To evaluate effects of Plasna Lyte A on recovery erythrocyte membraneNa＋-K＋-ATPenzyme activity and hemorheology. Methods Forty patients of orthopedics or cerebral surgery were prospectively enrolled. Patients were randomly assigned according to different washing fluid in two groups （n=20 for each）, Group Ⅰ. and group A. The erythroeyte membraneNa＋-K＋-ATP enzyme activity and hemorheology （include; TK, Arbc, EPT） were detected before operation and after blood recovery. Results Compare before blood recovery, Na＋-K＋-ATPenzyme activity decreased in two groups（P 〈0. 01）at after blood recovery and after autotransfusion, the Na＋-K＋-ATP enzyme activity of recovery erythroeyte membrane decreased more significantly in groups L （P〈0. 01）, but there was no significant different between the two groups after autotransfusion. TK of recovery erythroeyte were increased in two groups（P〈0. 01 ）, diversity of TK of recovery erythroeyte was significantly between the two groups （P〈 0.05）. Changes of Na＋-K＋-ATP enzyme activity and TK value in two groups before and after autotransfusion had no correlation （group L. r=0. 382, group A.. r=0. 0081）. Arbe was no significant change after autotransfusion within two groups and between two groups. After autotransfusion, all EPT values were shortened in two groups, there were no statistically significant differences. Conclusion Autotransfusion with Plasma Lyte A solution washing can improve the hemorheology of recovery RBC, and reduce the damage of recovery erythrocyte membrane Na＋-K＋-ATPenzyme activity. Improvement of washing fluid will increase quality of blood recovery, improve hemorheology and tissue oxygenation, furthermore, stabilize body physiological environment.

关 键 词：血液回收 红细胞 三磷酸腺苷 酶活性 

分 类 号：R614[医药卫生—麻醉学]