体外循环对血小板凝血酶敏感蛋白及纤维蛋白原含量的影响  

Influence of cardiopulmonary bypass on pletelet thrombospondin and fibrogen

作　　者：孙连高[1] 隋波[1] 李训美[1] 尹格平[2] 

机构地区：[1]济南军区总医院,250031 [2]济南军区总医院流式细胞仪室

出　　处：《临床麻醉学杂志》2001年第4期192-193,共2页Journal of Clinical Anesthesiology

摘　　要：目的　探讨体外循环心肺转流术 (CPB)期间血小板的灭活机制及临床意义。方法　用流式细胞术观察 40例先天性心脏病房、室间隔缺损患者在CPB下行心内修补术时的血小板凝血酶敏感蛋白 (Ts)及纤维蛋白原 (Fg)含量的变化 ,同时与本组患者试管内血小板Ts及Fg含量进行比较。结果　体外循环中血小板总数明显下降 ,从术前的 (310± 91)× 10 6/L降至术后的 (181± 44 )×10 6/L ,Ts及Fg含量均较术前有明显增加 (P <0 0 1) ,而试管内测定与之不符。结论　CPB期间Ts及Fg明显增加 ,表明Ts及Fg的粘附凝集功能增强 ,而凝血机制缺陷的原因可能与血小板总数下降、低温及肝素的后续作用有关。Objective To elucidate the mechanism of platelet dysfunction during cardioplumonary bypass(CPB).Methods The platelet thrombospondin(Ts) and fibrogen(Fg) were measured during operation by flow cytometry in 40 patients with atrial or ventricular septal defect,which was compared with Ts and Tg in vitro.Result A significant drop in platelet count was observed from preopetative (310±91)×106/L to postopwrative (181±44)×106/L.Ts and Fg increased significantly.These alterations were asymmetrical compared with Ts and Fg in vitro.Conclusion During CPB,Ts and Fg are increased.The coagulative dysfunction of blood may be related to platelet count drop,hypothermia and the residual effect of hepain.

关 键 词：心肺转流术 血小板 凝血酶敏感蛋白 纤维蛋白原 体外循环 

分 类 号：R654.1[医药卫生—外科学]